ORIGINAL PAPER
In individuals with unstable angina, insulin resistance has multiple connecting arms
1
Department of Chemistry, Faculty of Science, University of Kufa, Iraq
Submission date: 2024-08-26
Final revision date: 2024-09-27
Acceptance date: 2024-10-03
Publication date: 2025-09-29
Corresponding author
Maha Abdul Saheb Ridha
Maha Abdul Saheb Department of Chemistry Faculty of Science University of Kufa Iraq
Maha Abdul Saheb Department of Chemistry Faculty of Science University of Kufa Iraq
Medical Studies 2025;41(3):258-264
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Insulin resistance (IR) and unstable angina (UA) are two global public health threats. When UA patients have comorbid IR, they would suffer from serious complications, including atherosclerosis and dysregulation of some important pathways.
Aim of the research:
The present study used biomarkers of multiple pathways for the detection of IR in UA patients.
Material and methods:
We examined biomarkers of lipid profile, IR, endogenous opioids (β-endorphin (βEP) and µ-opioid receptor (MOR)) and vitamin D3 in patients with IR (UA + IR) (n = 35), without IR (UA-IR) (n = 41), and healthy controls (n = 45).
Results:
The triglycerides (TG), total cholesterol, very low-density lipoprotein cholesterol, HOMA index of β-cell function percentage (HOMA2%B), HOMA index of sensitivity (HOMA2%S), and Homeostatic Model Assessment of Insulin Resistance Index (HOMA2IR) were significantly different between the three diagnostic groups. There was a significant increase in uric acid, blood urea, creatinine, low-density lipoprotein cholesterol, κ-opioid receptor (KOR), endomorphin 2 (EM2), Castelli’s Risk Index I (CRI-I), Castelli’s Risk Index II (CRI-II), AG, Atherogenic Index of Plasma (AIP), interleukin (IL) 6 (IL-6), IL-10, IL-10/IL-6 ratio, βEP, MOR, and fasting blood sugar. Toll-like receptor 4 (TLR4) is higher in patient groups than controls, while there is a significant decrease in estimated glomerular filtration rate (eGFR), vitamin D (VD), βEP/MOR, and high-density lipoprotein cholesterol in both patient groups compared with the control group.
Conclusions:
The presence of IR state in UA patients is associated with various changes in serum biomarkers of some systemic arms.
Insulin resistance (IR) and unstable angina (UA) are two global public health threats. When UA patients have comorbid IR, they would suffer from serious complications, including atherosclerosis and dysregulation of some important pathways.
Aim of the research:
The present study used biomarkers of multiple pathways for the detection of IR in UA patients.
Material and methods:
We examined biomarkers of lipid profile, IR, endogenous opioids (β-endorphin (βEP) and µ-opioid receptor (MOR)) and vitamin D3 in patients with IR (UA + IR) (n = 35), without IR (UA-IR) (n = 41), and healthy controls (n = 45).
Results:
The triglycerides (TG), total cholesterol, very low-density lipoprotein cholesterol, HOMA index of β-cell function percentage (HOMA2%B), HOMA index of sensitivity (HOMA2%S), and Homeostatic Model Assessment of Insulin Resistance Index (HOMA2IR) were significantly different between the three diagnostic groups. There was a significant increase in uric acid, blood urea, creatinine, low-density lipoprotein cholesterol, κ-opioid receptor (KOR), endomorphin 2 (EM2), Castelli’s Risk Index I (CRI-I), Castelli’s Risk Index II (CRI-II), AG, Atherogenic Index of Plasma (AIP), interleukin (IL) 6 (IL-6), IL-10, IL-10/IL-6 ratio, βEP, MOR, and fasting blood sugar. Toll-like receptor 4 (TLR4) is higher in patient groups than controls, while there is a significant decrease in estimated glomerular filtration rate (eGFR), vitamin D (VD), βEP/MOR, and high-density lipoprotein cholesterol in both patient groups compared with the control group.
Conclusions:
The presence of IR state in UA patients is associated with various changes in serum biomarkers of some systemic arms.
REFERENCES (28)
1.
Paiva L, Vieira MJ, Baptista R, Ferreira MJ, Gonçalves L. Unstable angina: risk stratification for significant coronary artery disease in the era of high-sensitivity cardiac troponin. Glob Heart. 2024; 19: 7.
2.
Thygesen K, Alpert JS, Jaffe AS, Chaitman BR, Bax JJ, Morrow DA, White HD. Executive group on behalf of the joint European Society of Cardiology (ESC)/American College of Cardiology (ACC)/American Heart Association (AHA)/World Heart Federation (WHF) task force for the universal definition of myocardial infarction. Fourth universal definition of myocardial infarction (2018). Circulation. 2018; 138: e618-e651.
3.
Erkinovna KZ, Alisherovna KM, Davranovna MK, Nizamitdinovich KS. Correction of cytokine imbalance in the treatment of stable angina pectoris. Peerian J. 2022; 11: 64-70.
4.
Kosmas CE, Bousvarou MD, Kostara CE, Papakonstantinou EJ, Salamou E, Guzman E. Insulin resistance and cardiovascular disease. J Int Med Res. 2023; 51(3): 03000605231164548.
5.
Jain A, Mishra A, Shakkarpude J, Lakhani P. Beta endorphins: the natural opioids. Int J Chem Stud. 2019; 7(3): 323-332.
6.
Mousa RF, Smesam HN, Qazmooz HA, Al-Hakeim HK, Maes M. A pathway phenotype linking metabolic, immune, oxidative, and opioid pathways with comorbid depression, atherosclerosis, and unstable angina. CNS Spectrums. 2022; 27(6): 676-690.
7.
Cao D, Chiarito M, Mehran R. Treating inflammation prior to percutaneous coronary intervention: does the heart care? Circ Cardiovasc Interv. 2020; 13: e009127.
8.
Mourouzis K, Oikonomou E, Siasos G, Tsalamadris S, Vogiatzi G, Antonopoulos A, Fountoulakis P, Goliopoulou A, Papaioannou S, Tousoulis D. Pro-inflammatory cytokines in acute coronary syndromes. Curr Pharm Design. 2020; 26(36): 4624-4647.
9.
Rai H, Joner M, Wilson H, McGovern L, Richards G, Colleran R, Byrne RA. Interleukin-10-1082 G/A polymorphism and its association with early or severe presentation of coronary artery disease: a systematic review and meta-analysis. Cytokine. 2023; 162: 156103.
10.
Zhou A, Selvanayagam JB, Hyppönen E. Non-linear Mendelian randomization analyses support a role for vita- min D deficiency in cardiovascular disease risk. Eur Heart J. 2022; 43(18): 1731-1739.
11.
Algowhary M, Farouk A, El-Deek HE, Hosny G, Ahmed A, Abdelzaher LA, Saleem TH. Relationship between vitamin D and coronary artery disease in Egyptian patients. Egypt Heart J. 2023; 75(1): 92.
12.
De Loera-Rodriguez CO, Delgado-Rizo V, Alvarado-Navarro A, Agraz-Cibrian JM, Segura-Ortega JE, Fafutis-Morris M. Over-expression of TLR4-CD14, pro-inflammatory cytokines, metabolic markers and NEFAs in obese non-diabetic Mexicans. J Inflamm. 2014; 11: 39.
13.
De Luca C, Olefsky JM. Inflammation and insulin resistance. FEBS Letters. 2008; 582(1): 97-105.
14.
Bagheri B, Khatibiyan Feyzabadi Z, Nouri A, Azadfallah A, Mahdizade Ari M, Hemmati M, Darban M, Alavi Toosi P, Banihashemian SZ. Atherosclerosis and Toll-like receptor 4 (TLR4), lectin-like oxidized low-density lipoprotein-1 (LOX-1), and proprotein convertase subtilisin/kexin type 9 (PCSK9). Mediators Inflamm. 2024; 2024: 5830491.
15.
Members WC, Anderson JL, Adams CD, Antman EM, Bridges CR, Califf RM, Casey Jr DE, Chavey WE, Fesmi- re FM, Hochman JS. 2012 ACCF/AHA focused update incorporated into the ACCF/AHA 2007 guidelines for the management of patients with unstable angina/non–ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2013; 127(23): e663-e828.
16.
Matthews DR, Hosker JP, Rudenski AS, Naylor B, Trea- cher DF, Turner R. Homeostasis model assessment: insulin resistance and -cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985; 28: 412-419.
17.
Li S, Chen H, Zhou L, Cui H, Liang S, Li H. The uric acid to albumin ratio: a novel predictor of long-term cardiac mortality in patients with unstable angina pectoris after percutaneous coronary intervention. Scand J Clin Labor Investig. 2022; 82: 304-310.
18.
Flauzino T, Simão ANC, de Carvalho Jennings Perei- ra WL,Alfieri DF, Oliveira SR, Kallaur AP, Lozovoy MAB, Kaimen-Maciel DR, Maes M, Reiche EMV. Disability in multiple sclerosis is associated with age and inflammatory, metabolic and oxidative/nitrosative stress biomarkers: results of multivariate and machine learning procedures. Metab Brain Dis. 2019; 34: 1401-1413.
19.
Khalaji A, Behnoush AH, Khanmohammadi S, Ghanbari Mardasi K, Sharifkashani S, Sahebkar A, Vinciguerra C, Cannavo A. Triglyceride-glucose index and heart failure: a systematic review and meta-analysis. Cardiovasc Diabetol. 2023; 22(1): 244.
20.
Yi S, Cao H, Zheng W, Wang Y, Li P, Wang S, Zhou Z. Targeting the opioid remifentanil: protective effects and molecular mechanisms against organ ischemia-reperfusion injury. Biomed Pharmacother. 2023; 167: 115472.
21.
Moustafa SR. The immune-opioid axis in prediabetes: predicting prediabetes with insulin resistance by plasma interleukin-10 and endomorphin-2 to kappa-opioid receptors ratio. Diabetol Metab Syndr. 2021; 13(1): 61.
22.
Dziedzic EA, Gasior JS, Saniewski T, Dabrowski M. Vitamin D deficiency among Polish patients with angiographically confirmed coronary heart disease. Pol Merkur Lekarski. 2021; 49: 278-282.
23.
Dziedzic EA, Gąsior JS, Tuzimek A, Dąbrowski M, Jankowski P. Neutrophil-to-lymphocyte ratio is not associated with severity of coronary artery disease and is not correlated with vitamin D level in patients with a history of an acute coronary syndrome. Biology. 2022; 11(7): 1001.
24.
Dziedzic EA, Gąsior JS, Tuzimek A, Dąbrowski M, Kochman W. Correlation between serum 25-hydroxyvitamin D concentration, monocyte-to-HDL ratio and acute coronary syndrome in men with chronic coronary syndrome – an observational study. Nutrients. 2023; 15(20): 4487.
25.
Sarhan N, Essam Abou Warda A, Alsahali S, Alanazi AS. Impact of vitamin D supplementation on the clinical outcomes and epigenetic markers in patients with acute coronary syndrome. Pharmaceuticals. 2023; 16(2): 262.
26.
Milovanović B, Marinović D, Vuković V, Jezdimirović D. Vitamin D supplementation as a prevention of cardiovascular diseases. Sestrinska vizija. 2023; 7(13): 23-26.
27.
Sabico S, Wani K, Grant WB, Al-Daghri NM. Improved HDL cholesterol through vitamin D status correction substantially lowers 10-year atherosclerotic cardiovascular disease risk score in vitamin D-deficient Arab adults. Nutrients. 2023; 15(3): 551.
28.
Rivero A, Wehmeier KR, Haas MJ, Mooradian AD. Vitamin D, immune function, and atherosclerosis. Where are we now? Nutr Res. 2024; 133: 148-160.
Share
RELATED ARTICLE
| eISSN: | 2300-6722 |
| ISSN: | 1899-1874 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
