ISSN 2415-3060 (print), ISSN 2522-4972 (online)
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УЖМБС 2021, 6(1): 72–77
https://doi.org/10.26693/jmbs06.01.072
Clinical Medicine

Evaluation of Transforming Growth Factor-Β1 Levels in Patients with Coronary Heart Disease in Combination with Type 2 Diabetes Mellitus

Yeromenko R. F., Litvinova O. N., Kozar V. V., Litvinenko A. L., Karabut L. V.
Abstract

The purpose of the study was to examine the levels of transforming growth factor-β1 in the serum of patients with coronary heart disease in combination with type 2 diabetes and without it. Material and methods. We conducted a survey of 65 patients (25 men, 40 women) aged from 36 to 69 years (mean age was (59±3.5) years). All patients were diagnosed with coronary heart disease in the form of stable angina pectoris I-II functional classes. The group of examined patients included 33 patients with concomitant type 2 diabetes mellitus (mild form was in 15 people; moderate was in 18 people) and 32 patients without diabetes mellitus. The scope of the survey covered the generally accepted methods of clinical, laboratory and instrumental examination. The group of patients with coronary heart disease with type 2 diabetes had 14 (43%) men and 19 (57%) women (mean age was (62±2.6) years. Heart failure of stage I-II A (I-II functional classes) was diagnosed in 22 (68%) patients. The duration of coronary heart disease was from 3 to 15 years, the duration of type 2 diabetes lasted from 3 to 14. We detected hypertension in 19 (57%) patients, it was within 1-2 degrees (according to the criteria of the Ukrainian Association of Cardiologists, 2008). In the group of patients with coronary heart disease without diabetes there were 11 men (34%), 21 women (66%) (mean age was (57.0±2.4) years). Hypertension within 1-2 degrees was detected in 15 (46%) patients. Heart failure of I-II A stages (I-II functional classes) was diagnosed in 15 (46%) patients. The control group consisted of 15 practically healthy individuals who were representative by sex and age of patients from the study group and who did not have diseases of the cardiovascular system and endocrinopathies. The level of transforming growth factor-β1 in the blood serum was determined using sets of standard test systems "TGF-β1 ELISA" produced by company "DRG Instruments" (Germany). The level of native transforming growth factor-β1 in the serum was determined by solid-phase enzyme-linked immunosorbent assay. Results and discussion. Groups of patients with coronary heart disease with type 2 diabetes and without it could be compared by age, sex, duration and severity of coronary heart disease, the frequency of concomitant hypertension. At the same time, among patients with coronary heart disease with type 2 diabetes there was a higher frequency of heart failure. The results showed that probable increase in serum transforming growth factor-β1 levels in patients with coronary heart disease was more pronounced when combining coronary heart disease with type 2 diabetes. There was a significant increase in serum of transforming growth factor -β1 levels in patients with coronary heart disease both with type 2 diabetes and without it with a longer course of coronary heart disease and were severer, in patients with coronary heart disease with type 2 diabetes was with a longer course of diabetes. Analysis of the nature of changes in the levels of transforming growth factor-β1 in the serum of the examined patients with coronary heart disease with type 2 diabetes and without it, depending on gender, did not reveal any significant differences. The results of the study also indicated that in patients with coronary heart disease with type 2 diabetes and without it for all duration of coronary heart disease, the levels of this indicator in the serum were probably (p <0.05) higher than those in the control group. However, in patients with a significant duration of coronary heart disease (5-10 years and over 10 years) serum levels of transforming growth factor-β1 were probably (p <0.05) higher than in patients with a duration of coronary heart disease less than 5 years, and in the presence of and in the absence of type 2 diabetes. At the same time, for all periods of coronary heart disease, the levels of transforming growth factor-β1 in patients with type 2 diabetes were probably higher than in patients without diabetes. Conclusion. A probable increase in the levels of transforming growth factor -β1 in the serum of patients with coronary heart disease, which was more pronounced when combining coronary heart disease with type 2 diabetes. There was a significant increase in the levels of transforming growth factor-β1 in the serum of patients with coronary heart disease both with type 2 diabetes and without it with a longer course of coronary heart disease and its severe degree, in patients with coronary heart disease with type 2 diabetes especially with a longer course of diabetes. In order to increase the informativeness of assessing the risk of cardiovascular complications and the nature of coronary heart disease in patients with type 2 diabetes, the survey should include determination of serum levels of potent profibrogenic factor like transforming growth factor-β1

Keywords: coronary heart disease, type 2 diabetes mellitus, transforming growth factor-β1

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References
  1. Pankiv VI. Tsukrovyi diabet, pereddiabet i sertsevo-sudynni zakhvoryuvannya [Diabetes mellitus, pre-diabetes and cardiovascular diseases]. Praktychna anhiolohiya. 2017; 1(6): 4-10. [Ukrainian]
  2. Boyko AO, Zemlyachyk IV, Valihura YuB. Ryzyk urazhennya sertsevo-sudynnoi systemy u khvorykh iz riznoyu tryvalistyu tsukrovoho diabetu 2 typu [The risk of cardiovascular disease in patients with different duration of type 2 diabetes]. Visnyk medychnykh i biolohichnykh doslidzhen. 2019; 1: 5-8. [Ukrainian]
  3. Paul M. Physiology of local renin-angiotensin systems. Physiol Rev. 2006; 86: 747-803. https://doi.org/10.1152/physrev.00036.2005. PMid:16816138
  4. Pankiv VI. Tsukrovyi diabet: vyznachennya, klasyfikatsiya, epidemiolohiya, faktory ryzyku [Diabetes mellitus: definition, classification, epidemiology, risk factors]. Mizhnarodnyi endokrynolohichnyi zhurnal. 2013; 55(7): 95-104. [Ukrainian]
  5. Sakharnyi diabet: diahnostika, lechenie, profilaktika [Diabetes mellitus: diagnosis, treatment, prevention]. Pod red II Dedova, MV Shestakovoy. M: Meditsinskoe informatsionnoe ahentstvo; 2011. 808 s. [Russian]
  6. Mykhaylovska NS, Oliynyk TV. Biolohichni markery prozapalnoi aktyvatsiyi, dysfunktsiyi endoteliyu ta hiperkoahulyatsiyi u khvorykh na ishemichnu khvorobu sertsya ta hipotyreoz: vzayemozv'yazok z hormonamy hipofizarno-tyreoidnoi lanky [Biological markers of proinflammatory activation, endothelial dysfunction and hypercoagulation in patients with coronary heart disease and hypothyroidism: the relationship with pituitary-thyroid hormones]. Ukr kardiol zhurn. 2015; Dodatok 1: 99-112. [Ukrainian]
  7. Gordon KJ, Blobe GC. Role of transforming growth factor-β1 superfamily signaling pathways in human disease. Biochim Biophys Acta. 2008; 96: 197-228. https://doi.org/10.1016/j.bbadis.2008.01.006. PMid:18313409
  8. Gerard C, Blobe C, William P. Role of Transforming Growth Factor - β1 in Human Disease. N Engl J Med. 2000; 342: 1350-1358. https://doi.org/10.1056/NEJM200005043421807. PMid:10793168
  9. Grainger DJ. TGF - β1 and atherosclerosis in man. Cardiovasc Res. 2007; 74(2): 213-222. https://doi.org/10.1016/j.cardiores.2007.02.022. PMid:17382916
  10. Miller AM, Innes IB. Cytokines as therapentic targets to reduce cardiovascular risk in chronic inflammation. Curr Pharm Des. 2017; 17: 1-25. https://doi.org/10.2174/138161211795049796. PMid:21222645
  11. Sertsevo-sudynni zakhvoryuvannya. Klasyfikatsiya, standarty diahnostyky ta likuvannya [Cardiovascular diseases. Classification, standards of diagnosis and treatment]. Vseukr asots kardiolohiv. Za red VM Kovalenka. 3-te vyd, pererobl I dopov. K: Morion; 2018. 223 s. [Ukrainian]
  12. Madry H, Rey-Rico A, Venkatesan JK, Johnstone B, Cucchiarini M. Transforming growth factor Beta-releasing Scaffolds for cartilage tissue engineering. Tissue Eng Part B Rev. 2014 Apr; 20(2): 106-25. https://doi.org/10.1089/ten.teb.2013.0271. PMid:23815376
  13. Melnychenko HA, Dedov YY. Endokrynolohyya [Endocrinology]. Natsyonalnoe rukovodstvo. 2-e yzdanye, pererabotannoe y dopolnennoe. M: HEOTAR-Medya; 2020. 832 s. [Russian]
  14. Mizhnarodna Diabetychna Federatsiya (IDF) [International Diabetes Federation (IDF)]. [Internet]. [Ukrainian]. Available from: http://www.idf.org
  15. Hylyarevskyi SR. Novosty dokazatelnoy kardyolohyi [Evidence of Cardiology News]. [Internet] Ynternyst; 2018. [Russian]. Available from: https://internist.ru/broadcast/detail/34441/
  16. Stadnyk LA, Lapshyn OV. Tsukrovyi diabet 2 typu ta ryzyk rozvytku sertsevo-sudynnykh zakhvoryuvan: perspektyva intehratsiyi likarya ta vykladacha [Type 2 diabetes and the risk of cardiovascular disease: the prospect of integration of doctor and teacher]. Mystetstvo likuvannya. 2014; 2: 7-14. [Ukrainian]
  17. Seo J, Hare M. Transforming Growth Factor-β/Smad3 Pathway: Coming of Age as a Key Participant in Cardiac Remodeling. Circulation. 2007; 116(19): 2096-2098. https://doi.org/10.1161/CIRCULATIONAHA.107.735381. PMid:17984387
  18. Otsuka G, Stempien-Otero A, Frutkin A. Mechanisms of TGF-β1- induced intimal growth: plasminogen- independent activities of plasminogen activator inhibitor-1 and heterogeneous Origin of Intimal Cells. Circ Res. 2007; 100(9): 1300-1307. https://doi.org/10.1161/01.RES.0000266970.34017.8d. PMid:17431190
  19. Cosentino F, Grant P, Aboyans V, Bailey CJ, Ceriello A, Delgado V, et al. 2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD. Eur Heart J. 2020 Jan 7; 41(2): 255-323. https://doi.org/10.1093/eurheartj/ehz486. PMid:31497854