Inflammatory cardiovascular risk markers and silent myocardial ischemia in type 2 diabetic patients
Background/Aim. A special feature of coronary heart disease (CHD) in patients with type 2 diabetes mellitus (T2DM) is that it is often a symptomatic and occurs as a consequence of cardiovascular autonomic neuropathy. Dysregulation of the autonomic nervous system is associated with elevated values of...
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Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade
2022-01-01
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| Series: | Vojnosanitetski Pregled |
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| Online Access: | http://www.doiserbia.nb.rs/img/doi/0042-8450/2022/0042-84502100010M.pdf |
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| author | Malešević Gabrijela Popović-Pejičić Snježana Marković Aleksandra Soldat-Stanković Valentina |
| author_facet | Malešević Gabrijela Popović-Pejičić Snježana Marković Aleksandra Soldat-Stanković Valentina |
| author_sort | Malešević Gabrijela |
| collection | DOAJ |
| description | Background/Aim. A special feature of coronary heart disease (CHD) in patients with type 2 diabetes mellitus (T2DM) is that it is often a symptomatic and occurs as a consequence of cardiovascular autonomic neuropathy. Dysregulation of the autonomic nervous system is associated with elevated values of inflammatory markers such as high-sensitivity C-reactive protein (hs-CRP) and interleukin- 6 (IL-6), which accelerate atherosclerosis and the occurrence of cardiovascular complications in patients with T2DM. The aim of the study was to evaluate the importance of determining inflammatory cardiovascular risk markers IL-6 and hs-CRP in screening for the presence of CHD in asymptomatic patients with T2DM. Methods. The study included 169 patients with T2DM without any symptoms and signs of CHD. Ergometric testing proved or ruled out the presence of silent CHD. The levels of hs- CRP and IL-6 were determined by ELISA. Results. IL-6 values were significantly higher in patients with a positive ergometric test (6.83 ± 1.99 pg/mL) compared to patients with a negative ergometric test (3.04 ± 1.39 pg/mL) (p < 0.001). We also found that hs-CRP values in patients with a positive ergometric test were significantly higher compared to patients with a negative ergometric test (6.37 ± 2.25 vs 1.67 ± 1.41 mg/L; p < 0.001). Combinations of IL-6 and hs-CRP with age, HbA1c values, and duration of diabetes, presented through three binary logistic regression models, are significant predictors of silent CHD proven by ergometric testing, ie, with their increase, the probability of a positive ergometric test also increases (p < 0.01). The sensitivity of the associated finding of elevated IL-6 and hs-CRP values in the detection of silent CHD by ergometric testing was 90%, and the specificity was 86%. Conclusion. Hs-CRP and IL-6 are significant predictors of silent CHD, and their determination could be recommended for improving cardiovascular risk stratification in asymptomatic patients with T2DM. |
| format | Article |
| id | doaj-art-c977a632443c4eca8b7da718049110bf |
| institution | DOAJ |
| issn | 0042-8450 2406-0720 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Ministry of Defence of the Republic of Serbia, University of Defence, Belgrade |
| record_format | Article |
| series | Vojnosanitetski Pregled |
| spelling | doaj-art-c977a632443c4eca8b7da718049110bf2025-08-20T03:05:18ZengMinistry of Defence of the Republic of Serbia, University of Defence, BelgradeVojnosanitetski Pregled0042-84502406-07202022-01-0179658459010.2298/VSP201012010M0042-84502100010MInflammatory cardiovascular risk markers and silent myocardial ischemia in type 2 diabetic patientsMalešević Gabrijela0Popović-Pejičić Snježana1Marković Aleksandra2Soldat-Stanković Valentina3University Clinical Center of the Republic of Srpska, Department of Endocrinology, Diabetes and Metabolic Diseases, Banja Luka, Bosnia and Herzegovina + University of Banja Luka, Faculty of Medicine, Banja Luka, Bosnia and HerzegovinaUniversity Clinical Center of the Republic of Srpska, Department of Endocrinology, Diabetes and Metabolic Diseases, Banja Luka, Bosnia and Herzegovina + University of Banja Luka, Faculty of Medicine, Banja Luka, Bosnia and HerzegovinaUniversity Clinical Center of the Republic of Srpska, Department of Endocrinology, Diabetes and Metabolic Diseases, Banja Luka, Bosnia and Herzegovina + University of Banja Luka, Faculty of Medicine, Banja Luka, Bosnia and HerzegovinaUniversity Clinical Center of the Republic of Srpska, Department of Endocrinology, Diabetes and Metabolic Diseases, Banja Luka, Bosnia and Herzegovina + University of Banja Luka, Faculty of Medicine, Banja Luka, Bosnia and HerzegovinaBackground/Aim. A special feature of coronary heart disease (CHD) in patients with type 2 diabetes mellitus (T2DM) is that it is often a symptomatic and occurs as a consequence of cardiovascular autonomic neuropathy. Dysregulation of the autonomic nervous system is associated with elevated values of inflammatory markers such as high-sensitivity C-reactive protein (hs-CRP) and interleukin- 6 (IL-6), which accelerate atherosclerosis and the occurrence of cardiovascular complications in patients with T2DM. The aim of the study was to evaluate the importance of determining inflammatory cardiovascular risk markers IL-6 and hs-CRP in screening for the presence of CHD in asymptomatic patients with T2DM. Methods. The study included 169 patients with T2DM without any symptoms and signs of CHD. Ergometric testing proved or ruled out the presence of silent CHD. The levels of hs- CRP and IL-6 were determined by ELISA. Results. IL-6 values were significantly higher in patients with a positive ergometric test (6.83 ± 1.99 pg/mL) compared to patients with a negative ergometric test (3.04 ± 1.39 pg/mL) (p < 0.001). We also found that hs-CRP values in patients with a positive ergometric test were significantly higher compared to patients with a negative ergometric test (6.37 ± 2.25 vs 1.67 ± 1.41 mg/L; p < 0.001). Combinations of IL-6 and hs-CRP with age, HbA1c values, and duration of diabetes, presented through three binary logistic regression models, are significant predictors of silent CHD proven by ergometric testing, ie, with their increase, the probability of a positive ergometric test also increases (p < 0.01). The sensitivity of the associated finding of elevated IL-6 and hs-CRP values in the detection of silent CHD by ergometric testing was 90%, and the specificity was 86%. Conclusion. Hs-CRP and IL-6 are significant predictors of silent CHD, and their determination could be recommended for improving cardiovascular risk stratification in asymptomatic patients with T2DM.http://www.doiserbia.nb.rs/img/doi/0042-8450/2022/0042-84502100010M.pdfbiomarkersc-reactive proteincoronary diseasediabetes mellitus, type 2interleukin-6prognosis |
| spellingShingle | Malešević Gabrijela Popović-Pejičić Snježana Marković Aleksandra Soldat-Stanković Valentina Inflammatory cardiovascular risk markers and silent myocardial ischemia in type 2 diabetic patients Vojnosanitetski Pregled biomarkers c-reactive protein coronary disease diabetes mellitus, type 2 interleukin-6 prognosis |
| title | Inflammatory cardiovascular risk markers and silent myocardial ischemia in type 2 diabetic patients |
| title_full | Inflammatory cardiovascular risk markers and silent myocardial ischemia in type 2 diabetic patients |
| title_fullStr | Inflammatory cardiovascular risk markers and silent myocardial ischemia in type 2 diabetic patients |
| title_full_unstemmed | Inflammatory cardiovascular risk markers and silent myocardial ischemia in type 2 diabetic patients |
| title_short | Inflammatory cardiovascular risk markers and silent myocardial ischemia in type 2 diabetic patients |
| title_sort | inflammatory cardiovascular risk markers and silent myocardial ischemia in type 2 diabetic patients |
| topic | biomarkers c-reactive protein coronary disease diabetes mellitus, type 2 interleukin-6 prognosis |
| url | http://www.doiserbia.nb.rs/img/doi/0042-8450/2022/0042-84502100010M.pdf |
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