title: Lipid, adipokine and ghrelin levels in myocardial infarction patients with insulin resistance.
abstract: BACKGROUND
  Insulin resistance (IR) is a risk factor for ischaemic heart disease and myocardial infarction (MI). IR often manifests in MI and is regarded as an independent predictor of in-hospital mortality, which can provide early risk stratification for recurrent acute coronary events.
  
  
  METHODS
  The study enrolled 200 patients (130 males and 70 females aged 61.4 ± 1.12 years) diagnosed with ST elevation MI. At days 1 and 12 from the MI onset, IR levels and lipid profiles, as well as serum glucose, insulin, adipokine and ghrelin levels, were measured.
  
  
  RESULTS
  Free fatty acid (FFA) levels had the most pronounced changes: IR patients had a 9-fold increase in FFA levels at day 1, and patients without IR had a 6-fold increase. Leptin levels at days 1 and 12, in IR patients were, on average, 1.5- and 2-fold higher compared to the controls and patients with no IR (р < 0.05). Leptin levels in IR patients were increased throughout the entire hospital stay. Resistin levels in IR patients were, on average, 1.4-fold higher throughout the entire hospital stay, while in non-IR patients, resistin levels were similar to the controls. Adiponectin levels in IR patients were decreased compared to the controls, while in patients with IR, they were similar to the controls. Both IR and non-IR MI patients had 3-fold and 3.7-fold lower ghrelin levels at day 1, respectively, compared to the controls. The correlation analysis showed a negative correlation between ghrelin and FFA (r = -0.48 р = 0.007), ghrelin and leptin (r = -0.4 р = 0.003), ghrelin and insulin (r = -0.54 р = 0.002), and ghrelin and glucose (r = -0.31 р = 0.002) in MI patients.
  
  
  CONCLUSIONS
  Dyslipidaemia, along with insulinaemia and glycaemia, is one of the most significant IR risk factors in the acute and early recovery phases of MI. Dyslipidaemia is characterised by a high FFA level; an imbalance of leptin, resistin, and adiponectin; and a deficiency of ghrelin in the acute and early recovery periods of MI. FFA and ghrelin can be used as promising molecular markers to stratify the risk of recurrent acute coronary events and diabetes mellitus in MI patients.
authors.forename: Olga
authors.initials: O
authors.lastname: Gruzdeva
authors.affiliation: Research Institute for Complex Issues of Cardiovascular Diseases under the Siberian Branch of the Russian Academy of Medical Sciences, Kemerovo, Russia. evg.uchasova@yandex.ru.
authors.forename: Evgenya
authors.initials: E
authors.lastname: Uchasova
authors.forename: Ekaterina
authors.initials: E
authors.lastname: Belik
authors.forename: Yulia
authors.initials: Y
authors.lastname: Dyleva
authors.forename: Ekaterina
authors.initials: E
authors.lastname: Shurygina
authors.forename: Olga
authors.initials: O
authors.lastname: Barbarash
mesh_terms: D054392:Adipokines / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D050171:Dyslipidemias / Q000097:blood* / Q000503:physiopathology; D005230:Fatty Acids, Nonesterified / Q000097:blood*; D005260:Female; D054439:Ghrelin / Q000097:blood*; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D013997:Time Factors
chemical_list: D054392:Adipokines; D015415:Biomarkers; D001786:Blood Glucose; D005230:Fatty Acids, Nonesterified; C515349:GHRL protein, human; D054439:Ghrelin; D007328:Insulin