تقييم المؤشرات الحيوية الالتهابية ,التليفية والبروتين السكري 130 القابل للذوبان لدى الرجال المصابين بمرض السكري من النوع الثاني مع احتشاء عضلة القلب أو بدونه

Evaluating the Inflammatory, Fibrotic Biomarkers and Soluble Glycoprotein-130 in Type 2 Diabetic Patients Males with or without Myocardial Infarction

Abstract

Type 2 diabetes mellitus (T2DM) is one of the most important metabolic problems. The International Diabetes Federation (IDF) estimates that in 2019, 9.3% of the global adult population aged 20-79 years suffered from diabetes with a predicted rise to 10.2% and 10.9% by years 2030 and 2045, respectively. The prevalence of the disease in Iraq in 2021 was 9.4%. The association of heart diseases with T2DM, especially myocardial infarction, calls for a search for biomarkers that have a relationship between the two. It facilitates the process of reducing the development of myocardial infarction in patients with T2DM. The most prominent of these associations is long-term inflammation and its first and largest factor is interleukin 6, and its close association with disintegrin and metalloprotease (ADAM-17) and its inverse relationship with T2DM with and without myocardial infarction.
Complications of T2DM include high blood sugar that causes a decrease in ADAM-17 inhibitory proteins. Thus increasing its increased activity in cleaving and releasing many inflammatory cytokines such as interleukin 6 (IL-6), creating a long-term inflammatory environment.
The current study aims to investigate the role of ADAM-17 in the pathogenesis of Type 2 Diabetic Patients with or without Myocardial Infarction to see the association between ADAM-17, IL-6, and SGP130 levels and other biomarker.
The study was designed as a case-control study of 120 participants, sixty of them are T2DM with and without myocardial infarction, thirty patients per group, and sixty participants are apparently healthy as a control group. The study was conducted in the coronary care unit (CCU) at Kerbala Centre for Cardiac Diseases and Surgery and AL Hassan Center for Endocrinology and Diabetes in Karbala during the period from Jan. 2023 to Aug. 2023 .Thirty patients presented with typical chest pain to the coronary care unit (CCU). The diagnosis was based on clinical history, physical examination and confirmed by ECG, and investigation of a cardiac biomarker. Thirty patients with T2DM without MI attended the Alhassan Center for Endocrinology and Diabetes. They were diagnosed according to the analysis of random blood sugar and glycated hemoglobin. Sixty- nondiabetic persons )apparently healthy( were selected as a control group
The result obtained indicated that the overall, T2DM with or without myocardial infraction had a statistically significant increase in IL-6 and ADAM-17 mean values while the mean ± SD level of SGP-130 decreased statistically.The means ± SD of IL-6, ADAM-17, and SGP-130 of T2DM were (30.04±1.75, 3256.4±883.03 and 28.77±0.97) respectively. The means ± SD of the three biomarkers levels in the apparently healthy group were (23.44±1.46, 1645.33±41, and 39.17±17.99) respectively
In conclusion, The negative role of ADAM17 levels in diabetic patients was shown in both groups of patients with or without MI, and there was an involvement of ADAM17 in the pathogenesis of both groups, but the greatest effect was in diabetic patients without MI.
From all data and correlation of different variables in the present study, it was found presence of serum ADAM-17 and IL-6 was associated with an increase in the risk of type 2 diabetes and myocardial infarction in people with this disease. The level of the two biomarkers may serve as a predictor of type 2 diabetes complecation and myocardial infarction because their high sensitivity and specificity while the SGP-130 was a protective factor with low sensitivity and specificity.