Patologìâ (Dec 2024)
Levels of circulating catestatin in different clinical variants of coronary heart disease in patients with chronic heart failure and concomitant type 2 diabetes mellitus and obesity
Abstract
The aim is to assess the levels of circulating catestatin and to establish relationships with various clinical variants of coronary heart disease (CHD) in patients with chronic heart failure (CHF) and concomitant type 2 diabetes mellitus (T2DM) and obesity. Materials and methods. 154 patients were examined, divided into 4 groups according to the presence of metabolic disorders. Group 1 included patients with CHF with CHD and T2DM and obesity (n = 42). The second group consisted of patients with CHF on the background of CHD with T2DM (n = 46), the third group – with accompanying obesity (n = 36), the fourth group was formed from patients who had signs of heart failure of ischemic origin without metabolic disorders (n = 30). The control group consisted of 30 almost healthy persons of comparable age and sex. In addition, patients were divided into subgroups depending on the clinical form of CHD: stable angina, post-infarction cardiosclerosis (PICS) and diffuse cardiosclerosis. Results. Comparing the levels of circulating catestatin in groups 1, 2, 3 and 4, significantly lower levels of catestatin were found in patients with stable angina, compared to patients with diffuse cardiosclerosis by 73.25 %, 66.56 %, 69.86 % and 58.22 %, respectively (р ˂ 0.05). Comparison of catestatin levels revealed a decrease in catestatin levels in patients with stable angina compared to patients with PICS by 64.33 %, 63.70 %, 69.25 %, and 52.02 % in groups 1, 2, 3, and 4, respectively (р ˂ 0.05). Comparison of subgroups of diffuse cardiosclerosis and PICS did not reveal significant changes (р ˃ 0.05) in any group of patients. The indicators of catestatin in the control group had significant differences in the form of an increase in the concentration of the peptide, compared to patients with stable angina pectoris, PICS and diffuse cardiosclerosis in all studied groups (р ˂ 0.05). Evaluation of relationships between serum catestatin levels and clinical variants of coronary heart disease demonstrated a stable inverse relationship between catestatin and stable angina pectoris (r = -0.67, p ˂ 0.05) and PICS (r = -0.42, p ˂ 0.05), and with regard to metabolic diseases, a medium-strength inverse relationship with type 2 diabetes was also established (r = -0.54, p ˂ 0.05). Conclusions. The concentration of catestatin in blood serum had the lowest values in the group of patients with chronic heart failure of ischemic origin with concomitant diabetes mellitus type 2 and obesity, compared to the isolated course of chronic heart failure (p ˂ 0.05), which confirms the anti-inflammatory effects of catestatin and its connection with the insulin resistance progression. Among the clinical variants of coronary heart disease, the lowest levels of catestatin were demonstrated by patients with stable angina pectoris and post-infarction cardiosclerosis (r = -0.67 and r = -0.42, p ˂ 0.05, respectively), which indicates the association of this biomarker with various clinical variants of coronary heart disease.
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