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In order to assess systemic inflammation activity depending on the metabolic status and occupational influence of xenobiotic 96 patients with myocardial infarction aged 20-64 yy were assessed.
State of the lipid, carbohydrate, purine metabolism, body mass ratio, hair composition of 28 elements, blood levels of c-reactive protein, total fibrinogen, tumor necrosis factor-α were evaluated. Patients were randomized into 2 groups: 1st group (I) included patients who had occupational contact with xenobiotics, 2nd (II) – patients who had no contact with xenobiotics, control – 25 healthy subjects.
Myocardial infarction in 1st group patients under 50 y.o. develops predominantly on the background of normal values of lipid, carbohydrate, purine metabolism, low incidence of traditional cardiovascular risk factors and high activity of systemic inflammation evidenced by reliably higher levels of c-reactive protein (8,23±0,45 (I); 6,52±0,58 (II) (mg/l), p<0,05) and total fibrinogen (4,14±0,11 (І); 3,41±0,12 (ІІ) (g/l), p<0,05), compared to control and 2nd group. Regardless of occupation, higher mean level of c-reactive protein prevailed in patients younger than 50. Mean level of tumor necrosis factor-α was higher in older age (over 51) and prevailed in 2nd group what may be related to higher incidence of metabolic disorders (atherogenic dyslipidemia, overweight, diabetes mellitus, etc. (48,90±7,16 (І); 85,24±15,66 (pg/ml), p<0,01 (ІІ)). C-reactive protein and fibrinogen levels correlated with hair and plasma concentration of heavy metals: manganese, zinc, nickel, cobalt, cadmium, lead, strontium (r=0,484-0,990, p<0,01). Tumor necrosis factor-α analysis confirmed its strong relation with metabolic values: elevation of glycated hemoglobin, low density cholesterol, apolipoprotein-B.
Among patients younger than 50 who had occupational contact with xenobiotics myocardial infarction development is associated with high activity of systemic inflammation. Xenobiotics are capable to cause systemic inflammation and endothelial dysfunction, induce cytokine and acute phase proteins, resulting in acute coronary circulatory disorders even in absence of severe metabolic disorders. Continuous contact with technogeneous chemical substances causes more intense influence on c-reactive protein and fibrinogen elevation, metabolic disorders – on tumor necrosis factor-α. Combination of continuous occupational contact with xenobiotics with metabolic disorders results in reciprocal enhancement of proinflammatory effects and complicated duration of myocardial infarction.