Association between 1,5-anhydro-D-sorbitol, Insulin, and Incretins in Patients with Pre-diabetes and ST-elevation Myocardial Infarction

Sheryazdanova D. Laryushina Y. Vassilyeva N. Serikbayeva A. Alina A. Butyugina M. Tauesheva Z.
1 January 2022 Scientific Foundation SPIROSKI

Open Access Macedonian Journal of Medical Sciences
2022 #10 464 - 469 pp.

BACKGROUND: Pre-diabetes itself could be an independent predictor of such adverse cardiovascular events as myocardial infarction and ischemic stroke. Since pre-diabetes is linked with hyperinsulinism, it could also cause fluctuations of incretins concentration. Another significant fact related to pre-diabetes is glycemic variability. The impact of these factors on pre-diabetes and acute myocardial infarction is a promising phenomenon to the study. AIM: The study aims to estimate insulin, incretins, and glycemic variability in patients with impaired carbohydrate metabolism and acute myocardial infarction. METHODS: The 255 pre-diabetes patients participated in the observational case–control study. The first group included 85 patients hospitalized for ST-segment elevation myocardial infarction (STEMI). The second group included 170 patients without STEMI. Insulin and incretins were measured using a multiplex immunological assay with XMap technology on Bioplex 3D. The high-performance liquid chromatography with mass spectrometry was used to evaluate 1,5-AG concentration. The binary logistic regression was performed to evaluate the association between studying parameters and STEMI. RESULTS: The insulin secretion parameters showed higher insulin and C-peptide level in patients with STEMI. A similar trend was noted for the HOMA-IR index. Among incretin, we revealed a higher level of glucagon and reduced glucagon-like peptide-1 (GLP-1) in patients with STEMI. The level of 1,5-AG in STEMI patients was significantly lower than in non-STEMI patients. The logistic regression model shows that a lower plasma concentration of 1,5-AG increases the odds of STEMI in patients with pre-diabetes [OR 2.304 (95% confidence interval [CI] 1.980–2.973), p = 0.018]. Reduced GLP-1 concentration also increased the odds of STEMI [OR 1.775 (95% CI 1.460–1.990), p = 0.001]. CONCLUSION: We discovered the association between 1,5-AG, GLP-1, and STEMI in patients with pre-diabetes. It is designating their potential role as cardiovascular risk markers in non-diabetic patients with impaired glucose metabolism.

1,5-AG , Glucagon/GLP-1 , Insulin , Prediabetes , ST-elevation myocardial infarction

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Department of Internal Medicine, Karaganda Medical University, Karaganda, Kazakhstan

Department of Internal Medicine

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