MCP-1, dM2-PK and traditional risk factors for coronary artery disease among type II diabetes patients

Abstract

Inflammatory markers are considered promising new risk markers for coronary artery disease (CAD) as traditional risk factors have been unable to fully explain the increased risk of CAD in type II diabetes mellitus (T2DM) patients. Monocyte chemoattractant protein-1 (MCP-1), a CC chemokine, is involved in recruitment of monocytes to the arterial wall. Dimeric pyruvate kinase M2 (dM2-PK), a glycolytic enzyme, is elevated in conditions with high rate of inflammation and proliferation . The objective of the present study was to assess the association of two newer risk factors, MCP-1 and dM2-PK along with various traditional CAD risk factors, with T2DM patients. To the best of our knowledge, there hasn’t been any previous report on MCP-1 and dM2-PK as CAD markers in T2DM patients. Fasting blood samples were taken from N = 300 subjects including N = 100 T2DM patients with CAD, N = 100 T2DM patients without CAD, N = 50 CAD patients without any history of diabetes and N = 50 healthy subjects. Various traditional CAD risk factors i.e. obesity, total body fat, lipid profile and blood pressure were measured using standard procedures. Plasma MCP-1 and dM2-PK were quantitatively estimated by sandwich ELISA. Mean plasma MCP-1 concentration was significantly higher in diabetic patients with CAD than those without CAD. There was no significant difference in the mean plasma dM2-PK concentration among diabetic patients with and without CAD. In multivariate regression analysis, elevated plasma MCP-1 was significant risk factor for CAD in diabetic patients as well as non-diabetic subjects. MCP-1 was found to have a high sensitivity as a CAD marker. However dM2-PK was not significantly associated with CAD in diabetic patients as well as non-diabetic subjects. Among the traditional risk factors, age, duration of diabetes, reduced HDL-cholesterol (both sexes), increased SBP (females) and alcohol consumption (males) were significant risk factors for CAD in T2DM patients. Body mass index(BMI), Waist –Hip Ratio (WHR), percent body fat, cholesterol and LDL-cholesterol were significant risk factors in the non-diabetic subjects but not in diabetic patients. Hence the present study implied that plasma MCP-1, along with traditional risk factors (i.e. age, duration of diabetes and reduced HDL-cholesterol), could be used for identification of T2DM patients at risk of CAD.