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

Authors

  • A. V. Bolotskykh SI “Institute of Therapy named after L.T.Malaya of the NAMS of Ukraine”, Ukraine
  • Yu. S. Rudyk SI “Institute of Therapy named after L.T.Malaya of the NAMS of Ukraine”, Ukraine
  • S. M. Pyvovar SI “Institute of Therapy named after L.T.Malaya of the NAMS of Ukraine”, Ukraine

DOI:

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

Keywords:

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

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).

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.

Downloads

Published

2014-12-01

Issue

Vol. 18 No. 4 (2014)

Section

Clinical Pharmacology and Pharmacotherapy

License

Copyright (c) 2014 National University of Pharmacy

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Authors who publish with this journal agree to the following terms:

  1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
  2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
  3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).