Assessment of Adipokines, CXCL16 Chemokine Levels in Patients With Rheumatoid Arthritis Combined With Metabolic Syndrome

Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The study received intra-institutional funding and Scientific and technical program of Ministry of Healthcare of the Republic of Kazakhstan (program and target financing) [Development of scientific bases of formation of preventive environment in order to preserve the public health]. Publisher Copyright: © The Author(s) 2021.Objective: Rheumatoid arthritis (RA), which is a chronic systemic inflammatory disease, is associated with accelerated atherosclerosis and an increased risk of cardiovascular disease (CVD), but the causal factors have yet to be completely elucidated. The studies show that the prevalence of metabolic syndrome (MtS) was significantly higher in RA patients compared to the population. In RA and MetS inflammation and atherosclerosis are closely linked. The level of chemokines and adipokines, which may play a role in the development of atherogenesis in RA with MetS patients is currently unknown. In this study, we investigated the level of chemokine C-X-C motif chemokine ligand 16 (CXCL16) and adipokine in RA with MetS patients and assessed the association of biomarkers with clinical and biochemical activity scores of RA and components of MetS. Methods: Blood serum of 298 people (48—patients with RA and MetS, 82—with RA without MetS, 105—with MetS, 63—control group without both RA and MetS) was tested for (CXCL16), Resistin, Leptin and Fibroblast Growth Factor 21 (FGF21) levels by fluorescent antibody technique. Statistical analysis was performed using SPSS version 18.0. Results: The biomarker study showed the highest level in the RA with MetS patient group; but as compared with the RA group the differences were insignificant. CXCL16 (Me = 426.2 pg/ml (Q25-75 250.5-527.6), resistin (Me = 8685.4 pg/ml (Q25-75 6480.8-13 629.1), and FGF21 (Me = 443.6 pg/ml (Q25-75 772.9-916.3) proved to be significantly augmented in RA with MetS patients group, and in RA without MetS patients group (Me = 312.7 (Q25-75 199.4-517.7) pg/ml; Me = 8265.3 (Q25-75 5779.7-13 340.5) pg/ml; Me = 412.4 (Q25-75 300.4-497.4) pg/ml, respectively) as compared with MetS patients group (Me = 189.4 (Q25-75 130.3-280.6) pg/ml; Me = 5364.8 (Q25-75 2368.9-10 160.9) pg/ml; Me = 133.2 (Q25-75 76.2-268.6) pg/ml, respectively; P = <.001). Leptin level in all groups was higher than in the control group, but there were no differences between groups. The correlation analysis found a positive relationship between the leptin level and the waist circumference (rs = 0.39; P =.007) in the RA with MetS patients, the association of biomarkers with DAS28 score and ESR did not have any statistical significance. Conclusions: The augmented chemokine, resistin and FGF21 in the RA with MetS patients proves the systemic inflammation which is the basis of RA; the augmented leptin is linked to the abdominal obesity. These data are somewhat of an explanation of the increased risk of the CVD development in RA with MetS people. A differentiated specification can be useful to assess the cardiovascular risk of patients and justify prompt personalized treatment.publishersversionPeer reviewe

The Relationship Between the Level Fabp4, Risks of Type 2 Diabetes Mellitus, and Cardiovascular Events

BACKGROUND: The normoglycemic patients with diabetes risk and prediabetes have insulin resistance and consequently endothelial dysfunction that possible causes macroangiopathy and adverse cardiovascular events and further mortality of it. An early diabetes risk identification using not only prognostic scales but also biomarkers is starting and crucial point of struggle with 2 type diabetes mellitus and its complications. AIM: The aim of the study is to estimate the impact of FABP4 biomarker on diabetes risk and cardiovascular events. METHODS: A cross-sectional study was conducted simultaneously among 389 respondents aged 18–65 years. We provided survey and clinical examinations. The risk of diabetes was assessed using the FINDRISC scale and cardiovascular risk (CVR) was assessed using SCORE scale. The serum FABP4 biomarker was studied using a multiplex assay, immunofluorescence using XMap technology, a Bioplex 3D instrument, and a MILLIPLEX® Human cardiovascular disease panel I reagent kit(Millipore). Results were considered statistically significant at p &lt; 0.001. RESULTS: The group of type 2 diabetes mellitus (T2DM) high risk was 79 (20%) of all study participants. The level of the FABP4 marker significantly prevailed in high-risk group of T2DM and high CVR was also established this group. We found a positive direct average correlation(r = 0.59; p = 0.000) between FABP4 and FINDRISC scale. The logistic regression analysis indicated that the level of the FABP4 marker increases withing the increased risk of T2DM. The correlation between FABP4 concentration and CVR according to the SCORE scale (r = 0.24; p = 0,000) was lower than between FABP4 and diabetes risk. Risk factors were established affecting on the increasing CVR by SCORE scale in patients with T2DM risk. CONCLUSIONS: The level of FABP4 significantly prevailed in the group of diabetes and cardiovascular risk (CVR). The established correlations between FABP4 level and CVR or T2DM risk indicate on its increase in groups with a higher risk of type 2 diabetes and a high CVR

Insulin Resistance and Contrainsular Response in Type 2 Diabetes Mellitus Patients with Acute Coronary Syndrome

BACKGROUND: The number of patients with diabetes mellitus (DM) is progressively increasing all over the world. Over the past three decades, the global burden of diabetes has increased from 30 million in 1985 to 382 million in 2015, and current trends indicate that the prevalence of diabetes grows progressively. The phenomenon of insulin resistance established in the majority of type 2 DM (T2DM) patients. T2DM is associated with β-cell deficiency, α-cell resistance to insulin, and reduced effects of incretin. However, the role of insulin and glucagon in the process of cardiovascular complications in diabetic patients is a matter of debate. AIM: Our study aims to estimate insulin resistance and the contrainsular response in patients with T2DM and acute coronary syndrome (ACS). METHODS: The 104 T2DM patients aged 18–70 years participated in the observational study carried out in the Karaganda regional cardiosurgery hospital and ambulatory. The first group included 37 patients hospitalized for ACS in the first 24 h of admission. The second group included 67 patients without ACS. Determination of insulin resistance and contrainsular response was provided using a multiplex immunological assay with XMap technology on Bioplex 3D. RESULTS: During the research, we have discovered a decreased level of glucagon and increased homeostasis model assessment of insulin resistance (HOMA-IR) in patients with T2DM diabetes and ACS. Evaluation of traditional correlation interactions of HOMA-IR and indicators of carbohydrate metabolism showed a positive correlation with fasting plasma glucose in both study groups (Group 1: R = 0.47, p = 0.003; Group 2: R = 0.41, p = 0.024). Glucagon-like peptide (GLP)-1 has a weak positive correlation with HOMA-IR only in the first group (R = 0.32, p = 0.006). Increased insulin resistance was associated with high GLP-1 levels and low glucagon. The logistic regression model established that an increased HOMA-IR index rises the chance of ACS by 10.6% (OR = 1.106 [95% CI 1.105–1.206], p = 0,021). The logistic regression model, reflecting the relation between glucagon and ACS, shows that increased glucagon reduces the ACS odds (OR = 0.989 [95% CI 0.979–0.999], p = 0.026). The adjusted regression model showed no significant influence of early presented factors on the probability of ACS. CONCLUSION: There is a trend toward elevated HOMA-IR insulin resistance index and decreased level of glucagon in diabetic patients with ACS

Level of FABP3, FABP4, Nt-proBNP and Total Cardiovascular Risk in the Population of Central Kazakhstan

AIM: The study analyzed the level of cytokines playing the significant role in the diagnosis of circulatory system diseases and total cardiovascular risk.MATERIAL AND METHODS: The study involved 1,244 residents of Karaganda region. We had studied baseline participant characteristics, in addition to calculating the total cardiovascular risk and assessment of Fatty Acid Binding Proteins 3 (FABP3), Fatty Acid Binding Proteins 4 (FABP4) and N-Terminal Prohormone of Brain Natriuretic Peptide (NT-proBNP) level.RESULTS: The results showed the combination of high cardiovascular risk (CVR) with increased titers of cardiac markers, reflecting common pathogenic mechanisms in its development, among residents of Karaganda region.CONCLUSION: The combination of high CVR with the increased titers of cardiac markers showed common pathogenic mechanisms in its development, and support the diagnostic and prognostic value of these parameters among residents of Karaganda region, and also reflects the possibility to include these cardiac markers in the program of screening survey of population for early prevention of cardiovascular disease and its complications

The Association of Endothelin-1 with Early and Long-Term Mortality in COVID-19

(1) Background: Endothelial dysfunction is a key mechanism in the pathogenesis of COVID-19. High endothelin-1 during COVID-19 is associated with severe complications and increased mortality rates during hospitalization. This study is aimed to investigate the association of endothelin-1 levels with the risk of 30-day and 12-month all-cause mortality in patients with prior COVID-19. (2) Methods: A prospective study was conducted involving patients with COVID-19 in Karaganda, Kazakhstan. The level of endothelin-1 in the blood serum was evaluated by ELISA. Univariate and multivariate Cox regression was used to determine factors and significance of endothelin-1 associated with the risk of mortality within 30 and 365 days from hospitalization. (3) Results: The median endothelin-1 was higher in the group of patients who passed away within 30 days. The group showed statistically significant differences when compared to healthy volunteers from the control group (p = 0.0001), surviving patients (p = 0.001), and those who passed away within a year (p = 0.002). (4) Conclusions: Endothelin-1 levels are associated with increased mortality risk during the acute period of COVID-19, while plasma endothelin-1 level association with COVID-19 survivor mortality risk does not persist after 12 months

Informative Nature and Nonlinearity of Lagged Poincaré Plots Indices in Analysis of Heart Rate Variability

Lagged Poincaré plots have been successful in characterizing abnormal cardiac function. However, the current research practices do not favour any specific lag of Poincaré plots, thus complicating the comparison of results of different researchers in their analysis of heart rate of healthy subjects and patients. We researched the informative nature of lagged Poincaré plots in different states of the autonomic nervous system. It was tested in three models: different age groups, groups with different balance of autonomous regulation, and in hypertensive patients. Correlation analysis shows that for lag l = 6, SD1/SD2 has weak (r = 0.33) correlation with linear parameters of heart rate variability (HRV). For l more than 6 it displays even less correlation with linear parameters, but the changes in SD1/SD2 become statistically insignificant. Secondly, surrogate data tests show that the real SD1/SD2 is statistically different from its surrogate value and the conclusion could be made that the heart rhythm has nonlinear properties. Thirdly, the three models showed that for different functional states of the autonomic nervous system (ANS), SD1/SD2 ratio varied only for lags l = 5 and 6. All of this allow to us to give cautious recommendation to use SD1/SD2 with lags 5 and 6 as a nonlinear characteristic of HRV. The received data could be used as the basis for continuing the research in standardisation of nonlinear analytic methods