INSULIN RESISTANCE MARKERS IN PATIENTS WITH ST SEGMENT ELEVATION MYOCARDIAL INFARCTION
Abstract
In general population and among diabetic patients, insulin resistance (IR) is regarded as a cardiovascular risk factor. The aim of this study was to assess the dynamics of IR markers among non-diabetic and diabetic (Type 2 diabetes mellitus, DM-2) patients with acute myocardial infarction and ST segment elevation (STEMI) in the acute and early reconvalescent phases. In non-diabetic patients, clinical course of STEMI was characterised by IR development, postprandial hyperglycemia and hyperinsulinemia, as well as elevated levels of free fatty acids (FFA) and plasminogen activator inhibitor (PAI). Persistent high levels of FFA and PAI during stabilization phase in STEMI patients could justify the use of IR markers as one of the criteria for DM-2 risk and for the start of secondary prevention of metabolic MI complications.
About the Authors
O. V. GruzdevaRussian Federation
O. L. Barbarash
Russian Federation
Competing Interests:
O. E. Akbasheva
Russian Federation
E. I. Palicheva
Russian Federation
V. V. Kashtalap
Yu. A. Dyleva
A. A. Silonova
E. V. Tavlueva
References
1. Alessi M., Juhan-Vague I. PAI-1 and the Metabolic Syndrome: Links, Causes and Consequences. Arterioscler Thromb Vasc Biol. 2006; 26: 2200–2207.
2. Campbell I. W. The role of metformin and pioglitazone in early combination treatment of type 2 diabetes mellitus. British Journal of Diabetes & Vascular Disease. 2006; 6: 207–215.
3. Cefalu W. T. Insulin Resistance: Cellular and Clinical Concepts. Exp Biol Med. 2001; 226: 13–26.
4. Collet J. P., Montalescot G., Vicaut E., et al. Acute release of plasminogen activator inhibitor-1 in ST-segment elevation myocardial infarction predicts mortality. Circulation. 2003; 108: 391–394.
5. Huxley R., Barzi F., Woodward M. Excess risk of fatal coronary heart disease associated with diabetes in men and women: meta-analysis of 37 prospective cohort studies. BMJ. 2006; 332: 73–78.
6. Ishihara M., Kojima S., Sakamoto T., et al. Оn behalf of the Japanese Acute Coronary Syndrome Study (JACSS) Investigators. Acute hyperglycemia is associated with adverse outcome after acute myocardial infarction in the coronary intervention era. Am Heart J. 2005; 150: 814–820.
7. Juhan-Vague I., Morange P. E., Frere C., et al. HIFMECH Study Group. The plasminogen activator inhibitor-1–675 4G/5G genotype influences the risk of myocardial infarction associated with elevated plasma proinsulin and insulin concentrations in men from Europe: the HIFMECH study. J Thromb Haemost. 2003; 1: 2322–2329.
8. Katz A., Nambi S. S., Mather K., et al. Quantitative Insulin Sensitivity Check Index: a simple, accurate methods for assessing insulin sensitivity in humans. J Clin Endocrinol Metab. 2000; 85: 2402–2410.
9. Leclercq I. A., Silva M., B. Schroyen B., et al. Insulin Resistance in hepatocytes and sinusoidal liver cells: mechanisms and consequences. J Hepatol. 2007; 47 (1): 142–56.
10. Liang X., Kanjanabuch T., Mao S. L., et al. Plasminogen activator inhibitor-1 modulates adipocyte differentiation. Am J Physiol Endocrinol Metab. 2006; 290: 103–113.
11. Lopaschuk G., Ussher J., Folmes C., et al. Physiol. Myocardial Fatty Acid Metabolism in Health and Disease. Physiol Rev. 2010; 90: 207–258.
12. Lopez-Alemany R., Redondo J. M., Nagamine Y., et al. Plasminogen activator inhibitor type-1 inhibits insulin signaling by competing with alphavbeta3 integrin for vitronectin binding. Eur J Biochem. 2003; 270: 814–821.
Review
For citations:
Gruzdeva O.V., Barbarash O.L., Akbasheva O.E., Palicheva E.I., Kashtalap V.V., Dyleva Yu.A., Silonova A.A., Tavlueva E.V. INSULIN RESISTANCE MARKERS IN PATIENTS WITH ST SEGMENT ELEVATION MYOCARDIAL INFARCTION. Russian Journal of Cardiology. 2011;(6):9-13. (In Russ.)