Circulating endothelial-derived apoptotic microparticles and insulin resistance in non-diabetic patients with chronic heart failure
| Authors | |
|---|---|
| Year of publication | 2016 |
| Type | Article in Periodical |
| Magazine / Source | Clinical Chemistry and Laboratory medicine |
| MU Faculty or unit | |
| Citation | |
| Web | https://www.degruyter.com/view/journals/cclm/54/7/article-p1259.xml |
| Doi | http://dx.doi.org/10.1515/cclm-2015-0605 |
| Keywords | apoptotic endothelial-derived microparticles; chronic heart failure; insulin resistance |
| Description | Background: The objective of this study was to assess the relationship between insulin resistance and apoptotic endothelial-derived microparticles (EMPs) in patients with chronic heart failure (CHF). Methods: The study involved 300 CHF patients (186 males) aged 48-62 years with angiographically proven coronary artery disease and/or previously defined myocardial infarction. Insulin resistance was assessed by the homeostasis model assessment for insulin resistance (HOMA-IR). EMPs phenotype was determined by flow cytofluorometry. Results: Depending on HOMA-IR cut-off point (over and < 2.77 mmol/L x mu U/mL) all patients were divided into two cohorts with (n=171) or without (n=129) IR, respectively. Circulating EMPs were higher in CHF patients with IR than in patients without IR. Interestingly, EMPs were directly related to NYHA functional class of CHF, HOMAIR, NT-pro-BNP, hs-CRP and BMI. There was a significant association between the level of EMPs and HbA(1c), gender (r=0.318, p < 0.001 for male), age and smoking. On univariate and multivariate regression analysis we found that the NYHA class of CHF, NT-pro-BNP, hs-CRP, and left ventricular ejection fraction (LVEF) appeared to be independent predictors of increased circulatory apoptotic EMPs. The addition of HOMA-IR to the standard model (NYHA class CHF) improved the relative IDI by 19.9% for increased EMPs. For category-free NRI, 10% of events and 24% of non-events were correctly reclassified by the addition of HOMA-IR to the standard model for increased circulating EMPs. Conclusions: IR may be a contributing factor increasing circulating levels of apoptotic EMPs in non-diabetic CHF patients. |