[The role of inflammation factors in development of acute coronary syndrome in patients with type 2 diabetes mellitus and impaired glucose tolerance].
OBJECTIVE
To study the levels of inflammatory markers in acute coronary syndrome (ACS) and 6 months after its regression in patients with diabetes mellitus (DM) type 2; to evaluate effects of anxiodepressive disorders on inflammatory markers.


METHODS
The levels of high-sensitive C-reactive protein (hsCRP), interleukin-6 (IL-6), interleukin-18 (IL-18), monocyte-chemmoattractant-protein-1 (MCP-1) and soluble vascular cell adhesion molecules (sVCAM) were measured in blood samples, severity of depressive symptoms and the level of glycated haemoglobin (HbA1c) were assessed in 58 patients with type 2 DM during ACS and in 54 patients 6 months after ACS regression.


RESULTS
The levels of hsCRP and IL-18 correlate significantly with severity of myocardial lesion in ACS (p < 0.002; p < 0.009). Measurement of inflammatory markers 6 months after the discharge from hospital shows significant correlation between hsCRP, IL-18 and IL-6 levels; these levels were significantly lower in patients with HbA1c < 6.5% (tight glycemic control); there were associations between severity of depressive disorders and markers of inflammation (hsCRP, IL-18); analysis of MCP-1 and sVCAM levels 6 months after ACS regression shows a decrease of markers in 32-36% cases and an increase of markers in 64-67% cases.


CONCLUSIONS
Complex immunological reactions, chronic hyperglycemia and depresssive disorders play an important role in development of latent inflammation of the vascular wall in patients with type 2 diabetes mellitus and ACS.
Chazova
T E
TE
Masenko
V P
VP
Zykov
K A
KA
Golitsyna
T Iu
TIu
D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D018932:Chemokine CCL2 / Q000097:blood*; D003327:Coronary Disease / Q000097:blood / Q000209:etiology*; D003863:Depression / Q000097:blood / Q000150:complications; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications*; D018450:Disease Progression; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007249:Inflammation / Q000097:blood; D007333:Insulin Resistance; D020382:Interleukin-18 / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012720:Severity of Illness Index; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood*
D015415:Biomarkers; D002097:C-Reactive Protein; D018932:Chemokine CCL2; D006442:Glycated Hemoglobin; D020382:Interleukin-18; D015850:Interleukin-6; D019010:Vascular Cell Adhesion Molecule-1; C111835:CCL2 protein, human