Comparative analysis of Nε-carboxymethyl-lysine and inflammatory markers in diabetic and non-diabetic coronary artery disease patients

BACKGROUND Coronary artery disease(CAD)is a major cause of death worldwide,and India contributes to about one-fifth of total CAD deaths.The development of CAD has been linked to the accumulation of Nε-carboxymethyl-lysine(CML)in heart muscle,which correlates with fibrosis.AIM To assess the impact of CML and inflammatory markers on the biochemical and cardiovascular characteristics of CAD patients with and without diabetes.METHODS We enrolled 200 consecutive CAD patients who were undergoing coronary angiography and categorized them into two groups based on their serum glycosylated hemoglobin(HbA1c)levels(group I:HbA1c≥6.5;group II:HbA1c<6.5).We analyzed the levels of lipoproteins,plasma HbA1c levels,CML,interleukin-6(IL-6),tumor necrosis factor alpha(TNF-α),and nitric oxide.RESULTS Group I (81 males and 19 females) patients had a mean age of 54.2 ± 10.2 years, with a mean diabetes duration of4.9 ± 2.2 years. Group II (89 males and 11 females) patients had a mean age of 53.2 ± 10.3 years. Group I had moresevere CAD, with a higher percentage of patients with single vessel disease and greater stenosis severity in the leftanterior descending coronary artery compared to group II. Group I also exhibited a larger left atrium diameter.Group I patients exhibited significantly higher levels of CML, TNF-α, and IL-6 and lower levels of nitric oxide ascompared with group II patients. Additionally, CML showed a significant positive correlation with IL-6 (r = 0.596,P = 0.001) and TNF-α (r = 0.337, P = 0.001) and a negative correlation with nitric oxide (r=-4.16, P = 0.001). Oddsratio analysis revealed that patients with CML in the third quartile (264.43-364.31 ng/mL) were significantlyassociated with diabetic CAD at unadjusted and adjusted levels with covariates.

Prognostic performance of interleukin-10 in patients with chest pain and mild to moderate coronary artery lesions an 8-year follow-up study

Background Interleukin （IL）-10, IL-6 and their ratio （IL-6/IL-10） play an important role in the risk of developing coronary artery disease, and may correlate with its outcomes. Few clinical trials have investigated the prognostic impact of these factors on long-term car- diovascular events in patients presented with chest pain. Methods A prospective study was performed on 566 patients admitted with chest pain and identified mild to moderate coronary artery lesions. 1L-10, IL-6 and IL-6/IL-10 were measured. Results A total of 511 patients com- pleted the follow-up. The median follow-up time was 74 months. Kaplan-Meier analysis demonstrated a clear increase of the incidence of major adverse cardiac events during the follow-up period in patients with below-median levels of IL-10 （P = 0.006） and above-median levels of IL-6/IL-10 （P = 0.012）. Multivariate Cox proportional hazards analysis indicated the IL-10 levels to be strong independent predictors after adjustment for underlying confounders. Conclusions Elevated IL-10 levels are associated with a more favorable long-term prognosis in patients with chest pain and mild to moderate coronary artery lesions. IL-10 could be used for early risk assessment of long-term prognosis.

Effects of Liandou Qingmai Recipe(连豆清脉方) on Endothelin-1,Nitric Oxide,Interleukin-6 and Interleukin-10 Levels in Patients with Coronary Heart Disease

Objective:To observe effects of Liandou Qingmai Recipe(连豆清脉方) on endothelin-1(ET-1),nitric oxide(NO),interleukin-6(IL-6) and IL-10 levels in patients with coronary heart disease.Methods:Total 101 cases with coronary heart disease were randomly divided into a treatment group(n=45) treated by Liandou Qingmai Recipe and a standard treatment group(control group,n=56),with a normal group of 16 health persons set up.Changes of ET-1,NO,IL-6 and IL-10 levels were measured before treatment and after treatment for two weeks.And the data were analyzed by SPSS 16.0 statistic software.Results:Before treatment,the levels of ET-1,IL-6 and IL-10 levels were significantly higher and NO was significantly lower in the patients with coronary heart disease than those in the normal group(90.7±12.7 ng/L vs 41.8±13.5 ng/L,9.17±0.18 ng/L vs 1.10±0.08 ng/L,1.94±0.26 ng/L vs 1.09±0.06 ng/L,and 92.2±17.7 μmol/L vs 124.5±27.2 μmol/L;all P<0.05),with no significant differences in the levels of ET-1,NO,IL-6 and IL-10 between the treatment group and the control group(P>0.05);After treatment,ET-1 and IL-6 significantly decreased in the treatment group and the control group,and NO increased in the treatment group;And IL-6 level was significantly lower and NO level was higher in the treatment group than those in the control group(4.48±1.22 ng/L vs 5.13±1.85 ng/L,117.4±22.3 μmol/L vs 92.4±17.1 μmol/L;both P<0.05);There was a positive correlation between IL-6 and IL-10,and a negative correlation between NO and IL-10(r=0.142,r=-0.152;both P<0.05).Conclusion:Liandou Qingmai Recipe can decline IL-6,IL-10 and ET-1 levels,and raise NO level in patients with coronary heart disease on the basis of standard treatment,so as to inhibit endothelial inflammatory response,improve vascular endothelial function,with stronger anti-AS action;And vascular endothelial lesion is related with inflammatory response.

血清同型半胱氨酸、胱抑素C、白细胞介素-6水平与老年冠心病合并抑郁情绪的关系

目的探讨血清同型半胱氨酸、胱抑素C、白细胞介素-6水平与老年冠心病合并抑郁情绪的关系。方法收集老年冠心病患者103例,进行ZUNG抑郁自评量表(SDS)评分,根据评分结果分为冠心病伴有抑郁组与不伴抑郁组,记录年龄、性别、体质量指数等一般资料,并测定血清同型半胱氨酸、胱抑素C、白细胞介素-6,血脂水平等相关资料。结果 103例冠心病患者中男性46例(44.66%),女性57例(55.34%),伴有抑郁情绪59例(57.28%),其中男性有21例(35.6%),女性38例(64.5%),男女冠心病患者伴抑郁情绪差异有统计学意义,冠心病伴有抑郁组同型半胱氨酸、胱抑素C、白细胞介素-6明显高于对照组,差异均有统计学意义。结论同型半胱氨酸、胱抑素C、白细胞介素-6水平升高对老年冠心病抑郁情绪的发生、进展具有重要意义。

冠心病并发抑郁与血清白介素-6水平的关系

目的:分析冠心病(CHD)患者的心理状况,探讨血清白介素-6(IL-6)与CHD并发抑郁的关系,为临床提供CHD并发抑郁干预治疗的依据。方法:对90例CHD患者进行ZUNG抑郁自评量表(SDS)评分,根据评分结果分为CHD伴有抑郁组(A组)与不伴抑郁组(B组)。用放射免疫法测定血清IL-6的水平,并记录年龄、性别、吸烟、文化程度、糖尿病、高血压病史及血脂水平等相关资料。结果:入选的CHD患者57.58%伴有不同程度的抑郁,其中轻度抑郁者24例(26.67%),中、重度抑郁者28例(31.11%)。男性患者57.79%伴有抑郁,女性患者57.89%伴有抑郁;男、女性CHD患者抑郁并存率之间的差异无统计学意义。A组患者血清IL-6的水平[M(P25,P75]为[0.04(0.01,0.06)]μg/L,B组患者为[0.02(0.01,0.05)]μg/L,A组高于B组,差异有统计学意义(P<0.05)。A组中、重度抑郁患者血清IL-6水平为[0.05(0.02,0.08)]μg/L高于轻度抑郁IL-6水平为[0.04(0.01,0.05)]μg/L,差异有统计学意义(P<0.05)。结论:CHD患者有较高的抑郁并存率,CHD伴有抑郁患者血清IL-6的水平明显高于不伴有抑郁患者,中、重度抑郁患者血清IL-6的水平明显高于轻度抑郁。CHD伴有抑郁是体内具有炎性反应的一个标志,也即炎性反应在CHD并发抑郁中起着一定的作用。

疏肝护心汤联合氟哌噻吨美利曲辛治疗冠心病术后伴焦虑抑郁的疗效分析

【目的】评估疏肝护心汤(柴胡疏肝散加丹参、桂枝、瓜蒌皮等组成)联合氟哌噻吨美利曲辛对冠心病经皮冠状动脉介入术(PCI)后伴焦虑抑郁患者的治疗效果。【方法】回顾性收集广东省第二中医院2020年6月至2021年8月期间冠心病行PCI术后出现焦虑抑郁症状,中医证型为气滞血瘀证的65例患者的临床资料。根据治疗方式将患者分为观察组35例和对照组30例。2组患者均给予PCI术后常规的双重抗血小板治疗,对照组同时给予氟哌噻吨美利曲辛治疗,观察组在对照组的基础上联合疏肝护心汤治疗,疗程为4周。观察2组患者治疗前后汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、Morisky服药依从性量表(MMAS-8)评分及血清白细胞介素6(IL-6)、超敏C反应蛋白(hs-CRP)水平的变化情况,并进行为期1年的随访,以评价2组患者的远期焦虑抑郁改善疗效。【结果】(1)经过为期1年的随访,观察组的总有效率为100.00%(35/35),对照组为83.33%(25/30),组间比较,观察组的远期焦虑抑郁改善疗效明显优于对照组(P<0.05)。(2)治疗后,2组患者的HAMD、HAMA评分均较治疗前明显降低(P<0.05),MMAS-8评分均较治疗前明显升高(P<0.05),且观察组对HAMD、HAMA评分的降低作用和对MMAS-8评分的升高作用均明显优于对照组(P<0.01)。(3)治疗后,2组患者的血清IL-6、hs-CRP水平均较治疗前明显降低(P<0.05),且观察组对血清IL-6、hs-CRP水平的降低作用均明显优于对照组(P<0.01)。【结论】疏肝护心汤联合氟哌噻吨美利曲辛治疗冠心病PCI术后伴焦虑抑郁患者疗效确切,能有效改善患者焦虑抑郁症状,降低血清炎症因子水平,提高患者治疗依从性。

Relationship between coronary atherosclerosis plaque characteristics and high sensitivity C-reactive proteins, interleukin-6

Background The relationship between inflammatory markers and the characteristics of coronary atherosclerosis plaques is uncertain. The aim of the present study was to evaluate the relationship between the characteristics of coronary atherosclerosis plaques and inflammatory markers such as high sensitivity C-reactive proteins （Hs-CRP） and interleukin-6 （IL-6）. Methods All patients suspected of having coronary heart disease （CHD） underwent Siemens 64-slice CT angiography （64-SCTA） to distinguish the quality of plaque of coronary artery lesions. Blood samples were taken to measure levels of serum Hs-CRP and IL-6 in different plaque groups and the control group and compared with the value of 64-SCTA for detection of coronary artery plaque. Results The sensitivity of detecting coronary artery plaque by 64-SCTA was 87.4%, the specificity was 87.1%, the positive predictive value was 82.2%, and the negative predictive value was 91.0%. Comparing the levels of serum Hs-CRP and IL-6 among plaque groups, the mean levels of serum Hs-CRP and IL-6 in three plaque groups were significantly higher than those in the control group （P 〈0.01）. The mean levels of serum Hs-CRP and IL-6 in the soft plaque group and mixed plaque group were significantly higher than those in hard plaque group （P〈0.01）. Plaque burden in the soft plaque group and mixed plaque group was significantly higher than in the hard plaque group （P 〈0.01）, but there was no statistical difference between the soft plaque group and mixed plaque group （P=-0.246）. There was a negative correlation between the CT scale and Hs-CRP and IL-6 levels in the soft plaque group （r= -0.621, P〈0.01, and r= -0.593, P 〈0.01 respectively）. There was a positive correlation between the plaque burden and Hs-CRP and IL-6 levels in the soft plaque group （r=0.579, P〈0.05 and r=0.429, P〈0.05 respectively）. Conclusions 64-SCTA is an effective way to distinguish the different quality of coronary atherosclerosis plaque. Serum Hs-CRP and IL-6 levels can be considered as the indexes to judge the degree of CHD and may reflect the activity of plaque in CHD patients. Thus it is important for clinical diagnosis and risk evaluation of acute coronary syndrome （ACS） patients.

心理危机干预对老年冠心病患者炎性因子的影响

目的探讨心理危机干预对老年冠心病患者炎性因子水平的影响。方法选择老年冠心病患者270例,分别进行焦虑自评量表(SAS)及抑郁自评量表(SDS)调查,同时检测炎性因子水平,根据是否有焦虑、抑郁症状随即分为观察组180例和对照组90例。1年后重新对以上个体进行SAS和SDS评分及高敏C反应蛋白(hs-CRP)、TNFα、白细胞介素6(IL-6)水平检测。2组患者均进行常规冠心病治疗,同时对观察组额外进行心理危机干预。结果与对照组比较,观察组干预后SAS和SDS评分明显降低(P<0.05,P<0.01)。观察组焦虑、抑郁患者干预后SAS和SDS评分较干预前明显下降,观察组下降幅度较对照组更明显(P<0.01)。观察组干预后hs-CRP、TNF-α、IL-6水平较干预前明显下降(P<0.01),且观察组较对照组下降更明显(P<0.05)。结论心理危机干预可以减轻老年冠心病患者的焦虑、抑郁症状,降低炎性因子水平,但对无焦虑、抑郁患者影响较小。

同型半胱氨酸、白介素-1β、白介素-6与冠心病并发抑郁的关系

目的探讨血清同型半胱氨酸(Hcy)、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6与冠心病并发抑郁的关系。方法本研究对象为2019年1月~2022年1月我院100例冠心病患者,采用抑郁自评量表(SDS)进行抑郁筛查,设为抑郁组与非抑郁组,比较两组患者一般资料以及血清Hcy、IL-1β、IL-6水平,二元Logistic回归分析冠心病并发抑郁的影响因素。结果100例冠心病患者筛查出抑郁38例;抑郁组与非抑郁组病变程度、年龄、文化程度、血清Hcy、IL-1β、IL-6水平差异具有统计学意义(P<0.05),两组性别、高血压病史、糖尿病史、吸烟史差异无统计学意义(P>0.05);二元Logistic回归分析显示,三支病变、年龄>70岁、血清Hcy、IL-1β、IL-6水平是冠心病并发抑郁的影响因素。结论冠心病患者抑郁发生率较高,血清Hcy、IL-1β、IL-6水平、病变严重程度、年龄等是并发抑郁的影响因素。