Yelena Laryushina, Kazakhstan
Karaganda Medical University Department of the internal disease no 2Presenter of 1 Presentation
ASSOCIATION OF 1,5-ANHYDRO-D-GLUCITOL AND INSULIN RESISTANCE IN TYPE 2 DIABETES MELLITUS PATIENTS WITH ST SEGMENT ELEVATION MYOCARDIAL INFARCTION
Abstract
Background and Aims
The assessment of 1.5-AG and insulin resistance in patients with macrovascular complications of type 2 diabetes mellitus (T2DM) is the goal of this study.
Methods
We studied 114 patients with T2DM. First group included 42 patients with ST segment elevation myocardial infarction (STEMI), second group - 72 diabetic patients without STEMI. The studied parameters were clinical data, fasting blood glucose (FPG), glycosylated hemoglobin (HbA1c), 1,5-anhydro-D-glucitol (1,5-AG), and insulin. Statistical processing provided using Mann-Whitney U-test, Spearman's rank correlation coefficient, and binary logistic regression.
Results
There were 43.86% of men and 56.14% of women in the study. FPG in patients with STEMI (9.81 mmol/l, Q25-75:7.7-14.8) was higher (p=0.012) than in the second group (8.55 mmol/l, Q25-75:6.72-10.07). STEMI subjects had greater HOMA-IR (group 1: Me=7.91, Q25-75:2.86-11.37) compared with the second group (Me=5.89: Q25-75:1.73 -8.69, p=0.048). There was significant decrease of 1,5-AG among patients with T2DM and STEMI (first group: Me=215.85, Q25-75:186.35-280.77, second group: Me=314.64, Q25-75:250,83-415.08, p=0.000). The levels of insulin and HbA1c did not have significant differences between the groups. Weak positive correlation found between 1,5-AG and HOMA-IR for both groups (the first group r=0.183, p=0.008, the second group r=0.283, p=0.003). The negative association between 1,5-AG and STEMI established independent of such confounders as age, gender, income, hypoglycemic therapy [OR 1.16 (95%CI 1.0.25–1.316), p=0.019]. The association between HOMA-IR shows no impact on STEMI after adjusted on confounders. [OR 1,016 (95% CI0,979-1,055), p=0.406]
Conclusions
Association of 1.5 AD and STEMI suggests its potential predictive role on negative cardiovascular events prediction.