Characteristics of inflammatory markers in patients with type 2 diabetes mellitus and evolution of ST-elevation acute myocardial infarction in patients of the Buryat population

BACKGROUND. Type 2 diabetes mellitus (T2DM) and diseases of the circulatory system continue to be one of the important health problems, given their high prevalence and comorbidity. Acute ST-segment elevation myocardial infarction (STEMI) in type 2 patients (T2DM) is characterized by a severe course with adverse clinical outcomes. Currently, the features of STEMI in patients with T2DM in different ethnic groups remain insufficiently studied.

AIM. To determine the patterns of inflammatory response in patients with type 2 diabetes mellitus and acute ST-segment elevation myocardial infarction in the Buryat population.

MATERIALS AND METHODS. An observational single-center simultaneous comparative study was conducted on the basis of the Department of Endocrinology of IGMAPO, a branch of the Federal State Budgetary Educational Institution of the Russian Ministry of Health, and the N.A. Semashko Republican Clinical Hospital in Ulan-Ude of the Ministry of Health of the Republic of Buryatia. The study included patients with T2DM and STEMI with the participation of a control group. Anamnesis was collected from all participants of the study, and a clinical and functional examination was performed. In all subjects, serum levels of interleukin-1β (IL-1β), interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10 (IL-10), tumor necrosis factor-α (TNF-α) were detected by the method of solid-phase enzyme immunoassay, while the immunoturbidimetric method was used to detect the level of high-sensitivity C-reactive protein (hs-CRP). In patients with T2DM and STEMI, venous blood sampling was performed on an empty stomach in the first 24 hours after the development of an angina attack.

RESULTS. The study included 77 people who were divided into patients of the Russian and Buryat populations, depending on their ethnic status. The group of the Russian population consisted of 21 patients with T2DM and STEMI and 22 people in the control group. The Buryat population group included 14 patients with T2DM and STEMI and 20 people in the control group. Russian population showed an increase in inflammatory response parameters (IL-1β, IL-6, IL-10, TNF-α, hs-CRP) in patients with T2DM and STEMI relative to the control group of the Russian population (p<0.01). There was registered a significant increase in the levels of IL-1β, IL-6 and hs-CRP in patients with T2DM and STEMI in the Buryat population compared with the indicators of the control group of Buryats (p<0.05). Comparative analysis showed that patients with T2DM and STEMI in the Buryat population are characterized by a decrease in the inflammatory response with cytokine decrease, both pro-inflammatory (IL-6) and anti-inflammatory (IL-10) against the background of a decrease in hs-CRP, relative to patients with T2DM and STEMI in the Russian population (p<0.05).

CONCLUSION. The results obtained indicate an imbalance of the cytokine system on the first day of the acute period in patients of the Buryat population with T2DM and STEMI against the background of a decrease in the anti-inflammatory link relative to patients with T2DM and STEMI in the Russian population.

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