The role of insulin resistance in patients with heart failure with preserved systolic function of the left ventricle

A. V. Bolotskykh, Yu. S. Rudyk, S. M. Pyvovar

Abstract


The serum levels of TNF-α, Gal-3 in patients with heart failure with preserved systolic function (HFPSF) with and without insulin resistance (IR) and type 2 diabetes mellitus (T2DM) and their relationship have been investigated. Seventy-two patients (39 males and 33 females; the average age is 62.1±9.2 years old) with HFPSF of ischemic genesis, EF LV > 45% with and without concomitant IR and T2DM were examined. The content of Gal-3, TNF-α and insulin were measured in the serum by ELISA according to the manufacturer’s instructions. The Homeostasis Model Assessment (HOMA) index was calculated as a measure of IR at fasting state (IR=fasting glucose . fasting insulin/22.5), after that the patients were divided into three groups: 30 patients with HFPSF and IR, 31 patients with HFPSF and T2DM and 11 patients with HFPSF and without T2DM and IR. Spearman’s correlation analysis and Kruskal-Wallis test were used. All statistical tests were 2-tailed, and p<0.05 was considered statistically significant. The results obtained showed that Gal-3, TNF-α and insulin levels in patients with HF and IR were significantly higher than in patients with HF without IP and T2DM and patients with HF and T2DM (p<0.05, p<0.05 and p<0.0001, respectively). The association between Gal-3 level and the ratio of transmitral flow peak velocities (E/A) (r = -0.272; p<0.05); the serum TNF-alpha levels (r = 0.610; p<0.001); insulin levels (r = 0.331; p<0.01); the value of HOMA index (r = 0.293; p<0.02) was found. Significant relationships of the serum Gal-3 and serum TNF-α levels in patients with HF and IR and patients with HF and T2DM was also revealed. The reliability of difference in the strength of relationship was searched. Analysis has shown that the strength of the serum level relationship of TNF-α and Gal-3 increases from patients with HF and IR (r = 0.520) to patients with HF and T2DM (r = 0.709) (prr<0.05).


Keywords


insulin resistance; tumor necrosis factor alpha; galectin-3; heart failure with preserved systolic function of the left ventricle; type 2 diabetes mellitus

References


Визир В.А., Попов В.В., Копица Н.П. и др. // Серце і судини. – 2011. – №2. – С. 108-113.

Гайдаєв Ю.О. // Междунар. эндокринол. журн. – 2009. – №2 (4). – С. 9-14.

Драпкина О.М., Гегенава Б.Б. // Рациональная фармакотерапия в кардиол. – 2013. – №9 (1). – С. 62-65.

Жердьова Н.М. // Укр. мед. часопис. – XI/XII 2013. – Вип. 6 (98). – С. 53-54.

Рекомендації Асоціації кардіологів України з лікування хронічної серцевої недостатності у дорослих (перегляд 2011 року).

Целуйко В.И., Вашакидзе З.С., Мотылевская Т.В. и др. // Ліки України. – 2011. – №4 (8). – С. 32-35.

Уильямз Г., Пикап Д. Руководство по диабету. – М.: МЕДпресс-информ, 2003. – 248 с.

Bauters C., Lamblin N., McFadden E.P. et al. // Cardiovasc. Diabetol. – 2003. – Vol. 2. – P. 1-16.

Calvier L., Miana M., Reboul P. et al. // Arterioscler. Thromb Vasc. Biol. – 2013. – Vol. 33 (1) – P. 67-75.

Candido R., Forbes J.M., Thomas M.C. et al. // Circ Res. – 2003. – Vol. 92. – P. 785-792.

deFilippi C.R., Felker G.M. // US Cardiol. – 2010. – Vol. 7. – P. 67-70.

Diez J. // J. Clin. Hypertens. (Greenwich). – 2007. – Vol. 9. – P. 546-550.

Dumic J., Dabelic S., Flögel M. // Biochim. Biophys. Acta. – 2006. – Vol. 1760. – P. 616-635.

Fasshauer M., Paschke R. // Diabetol. – Vol. 46 (12). – P. 1594-1603.

Gast K.B., Tjeerdema N., Stijnen T. et al. Insulin resistance and risk of incident cardiovascular events in adults without diabetes: meta-analysis. // PLoS ONE 7, e52036 (2012).

Giacco F., Brownlee M. // Circ. Res. – 2010. – Vol. 107. – P. 1058-1070.

International Diabetes Federation. IDF Diabetes Atlas, 6th ed. (International Diabetes Federation, 2013).

Jellis C., Wright J., Kennedy D. еt al. // Circulation: Cardiovasc. Imaging. – 2011. – Vol. 4. – P. 693-702.

McAlister F., Berry C., Doughty R.N. et al. // Eur. Heart J. – 2012. – Vol. 33. – P. 1750-1757.

Melvin R. // Insulin. – 2006. –Vol. 1. – Р. 22-37.

Mehra V.C., Ramgolam V.S., Bender J.R. // J. Leukoc. Biol. – 2005. – Vol. 78 (4). – P. 805-818.

Owan T.E., Hodge D.O., Herges R.M. et al. // N. Engl. J. Med. – 2006. – Vol. 355. – P. 251-259.

Poornima I.G., Parikh P., Shannon R.P. // Circ. Res. – 2006. – Vol. 98. – P. 596.

Porter K.E., Turner N.A. // Pharmacol. Ther. – 2009.– Vol. 123 (2). – P. 255-278.

Ritchie S.A., Ewart M.N., Perry C.G. et al. // Clinical Sci. – 2004. – Vol. 107. – P. 519-532.

Sangaralingham S.J., Huntley B.K., Martin F.L. et al. // Hypertens. – 2011. – Vol. 57. – P. 201-207.

Sarwar N., Gao P., Seshasai S.R. et al. // Lancet. – 2010. – Vol. 375. – P. 2215-2222.

Sarwar N., Sattar N., Gudnason V., Danesh J. // Eur. Heart J. – 2007. – Vol. 28 – P. 2491-2497.

Strissel K.J., Stancheva Z., Miyoshi H. // Diabetes. – 2007. – Vol. 56 (12). – P. 2910-2918.

Tabet J.Y., Lopes M.E., Champagne S. et al. // Arch. Mal. Coeur. Vaiss. – 2002. – Vol. 95 (3). – P. 204-212.

Wakasaki H., Koya D., Schoen F.J. et al. // Proc. Natl. Acad. Sci. USA. – 1997. – Vol. 94. – P. 9320-9325.

Wong C., Marwick T.H. // Nat. Clin. Pract. Cardiovasc. Med. – 2007. – Vol. 4. – P. 436-443.

Yu Q., Gao F., Ma X.L. // Cardiovasc. Res. – 2011. – Vol. 89. – P. 516-524.


GOST Style Citations






DOI: https://doi.org/10.24959/cphj.14.1314

Abbreviated key title: Klìn. farm.

ISSN 2518-1572 (Online), ISSN 1562-725X (Print)