RELATIONSHIP BETWEEN CARBOHYDRATE METABOLISM VALUES AND CALPROTECTIN LEVELS IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION WITH REGARD TO CONCOMITANT TYPE 2 DIABETES MELLITUS.
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Resum
According to literature, the presence of concomitant diabetes mellitus type 2 (DM) is associated with a high frequency of complications in patients with acute myocardial infarction (MI) due to the development of repeated episodes of myocardial ischemia, left ventricular dysfunction, life threatening rhythm disorders, and thromboembolic events Aim: to analyze the state of immuno-inflammation based on the study of calprotectin, as well as to assess the presence and nature of links with carbohydrate metabolism parameters based on the study of blood glucose, insulin and insulin resistance. Patients with AMI in combination with DM 2 were found to have a significant increase in the level of calprotectin by 25.9% (p<0.001) compared to patients with AMI without DM 2. Assessment of carbohydrate metabolism rates revealed changes in the form of statistically significant increase in the concentration of fasting glucose in patients with AMI in combination with DM 2 by 41.8% (p<0.001) when compared to patients with isolated AMI. As for serum insulin, the level of this parameter when combined with the course of AMI and DM 2 significantly exceeded those in patients with AMI without DM 2. The level of HOMA index in patients with AMI with concomitant DM 2 when compared to patients with isolated AMI was also higher (differences are statistically significant, p<0.01). The study showed a correlation between serum calprotectin and insulinemia (R=0.57; p<0.05), HOMA index (R=0.52; p<0.05), fasting glycemia (R=0.59; p<0.05) and troponin I level (R=0,64; p<0,05). The obtained results indicate that the growth of immune inflammatory activity due to the proinflammatory parameter of calprotectin is accompanied by an increase in changes in carbohydrate homeostasis in the form of an increase in the degree of insulin resistance in patients with AMI and DM 2, and severity of cardiac ischemia.
