Inflamatorni i hemostatski kardiovaskularni markeri rizika u toku akutne hiperglikemske krize u tipu 1 i tipu 2 dijabetesa

Abstract

Uvod: Analizirali smo kardiovaskularne inflamatorne (Creaktivni protein (CRP), interleukin 6 (IL-6)) i (homocistein) hemotatske markere rizika u negojaznih i gojaznih pacijenata pri prijemu i razrešenju akutne hiperglikemijske krize (AHK), uključujući dijabetesnu ketoacidozu (DKA) i hiperosmolarno hiperglikemijsko stanje (HHS). Metode: U tom kontekstu uključili smo grupu A: N = 20 gojaznih, B: N = 20 negojaznih bolesnika sa DKA; C: N = 10 gojaznih, D: N = 10 negojaznih bolesnika sa HHS; E: N = 15 gojaznih, F: N = 15 negojaznih kontrola. Nivo CRP IL-6 i homocistein određeni su ELISA metodom. Rezultati: Naši rezultati su pokazali niže nivoe CRP IL-6 i homocisteina nakon rešavanja AHK u poređenju sa prijemom u svim grupama: (A: p LT 0,001; B: p LT 0,001, C: p LT 0,05; D: p LT 0,001 mg/L), (A: p LT 0,001 B: p LT 0,001; C: p LT 0,05, D: p=0,001 mmol/L), (A: p LT 0,001, B: p LT 0 ,001 , C: p LT 0,001, D: p LT 0,01 pg/mL) nakon rešavanja AHK. Međutim, nivo CRP je ostao viši (p LT 0,001, p LT 0,01), IL-6 niži (p LT 0,05, p LT 0,001), dok je nivo homocisteina sličan u poređenju sa kontrolama. Zaključak: AHK su povezane sa povišenim nivoom inflamatornih i hemostatičnih kardiovaskularnih markera rizika. Takođe, terapija insulinom u AHK ima značajno povoljniji efekat na nivo IL-6 i homocisteina, nego na nivo CRP

Background: We analyzed cardiovascular inflammatory (Creactive protein (CRP), interleukin 6 (IL-6)), haemostatic (homocysteine) risk markers in lean and obese patients at admission and acute hyperglicemic crisis (AHC) resolving, involving diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS). Methods: In that context, we included group A: N = 20 obese, B: N=20 lean patients with DKA; C: N = 10 obese, D: N=10 lean patients with HHS; E: N = 15 obese, F: N = 15 lean controls. CRP IL-6, homocysteine were determined by ELISA. Results: Our results showed that CRP IL-6, and homocysteine levels decreased in all groups: (A: p LT 0.001; B: p LT 0.001, C: p LT 0.05; D: p LT 0.001 mg/L), (A: p LT 0.001 B: p LT 0.001, C: p LT 0.001, D: p LT 0.01 pg/mL), (A: p LT 0.001, B: p LT 0.001; C: p LT 0.05, D: p=0.001 pmol/L), respectively, at resolving AHC. However, CRP persisted higher (p LT 0.001, p LT 0.01), IL-6 lower (p LT 0.05, p LT 0.001), while homocysteine levels turned out to be similar to controls. Conclusions: AHC is associated with increased inflammatory and hemostatic cardiovascular risk markers. Also, insulin therapy in AHC has had more pronounced favorable effect on IL-6 and homocystein than on CRP.