Author + information
- Galina Kukharchik1,2,
- Olga Lebedeva1,2,
- Alexey Ermakov1,
- Larisa Gaikovaya1,
- Viktoria Dmitrieva1 and
- Olga Abramova2
to evaluate the activity of monocytes and the severity of endothelial dysfunction in patients with acute myocardial infarction (AMI) and type 2 diabetes mellitus (DM).
74 patients with AMI were included in the study: 1 group - 36 patients with type 2 DM, 2 group - 38 patients without type 2 DM. The content of leukocytes, monocytes and their subpopulations (“classical” M1-CD14+CD16- and «nonclassical» M2-CD14+CD16+), circulating endothelial cells (CEC) were determined by cytoflowmetry on days 1, 3 and 14 of AMI. The count of CEC was calculated for 100,000 leukocytes. The lymphocyte-to-monocyte ratio (LMR) was defined as the ratio of the mean count of lymphocytes to the number of monocytes. Statistical analysis was performed with STATISTICA 10.0.
The average age of the patients was 68.3 ± 4.1 years. No differences in age between groups were detected. The level of leukocytes in the first day of AMI was increased in patients from the 1 group up to 11.38±4.8x109/ L and from the 2 group up to 11.075±2.76x109/L (p>0.05). On third day in both groups, the level of leukocytes was similar and decreased by the 14thday. Patients of both groups had monocytosis, which decreased during the observation. The number of M1 in the first day in the 1 and 2 groups was 844.2±374.2/μl and 869.6±404.1/μl, respectively (p>0.05); on the third day – 703.5±260.4/μl and 646.3±200.1/μl, respectively (p>0.05); on the 14th day – 546.7±155.8/μL and 655±229/μl, respectively (p>0.05). The amount of M2 on first day was 90.5±41.2/μl in the 1 group, 58.3±41.0/μl in the 2 group (p<0.05); on the third day - in the 1 group—80.5±42.2/μL, in the 2 group – 57.6±30.5/μl (p<0,05). On the 14th day, the M2 count was significantly higher in patients with AMI in combination with type 2 diabetes than in patients without type 2 diabetes (69.9±41.3/μL and 46.3±19/μl, respectively, p<0.05). LMR in patients from 1 group on the first day and 14th day was higher in comparison with the patients from the 2 group (2.4±1.2 vs 1.8±1.1, p<0.05; 4.1±1.3 vs 2.9±1.2, p<0.05). The content of CEC in the first day of AMI was similar in the 1 and 2 groups (17.53±7.6 vs 17.5±6.8, respectively, p>0.05). On the third day of AMI, the level of CEC in patients from 1 group was 19.65±6.4, and from the 2 group – 15.6±5.7 (p <0.05). On the 14th day, the number of CECs in 1 group patients was significantly higher in comparison with 2 group patients (25.81±5.8 and 20.1±8.7, respectively, p<0.05).
leukocytosis and monocytosis are observed in patients with AMI on the first day and up to 14thday. LMR is elevated in patients with type 2 diabetes on the 1st and 14th days, which indicates the predominance of the affective immunity in this group of patients. Unlike patients without type 2 diabetes, the number of “nonclassical” monocytes in patients with type 2 diabetes is higher, indicating a more pronounced inflammatory response. A significantly higher level of circulating endothelial cells in patients with type 2 diabetes is a sign of more severe endothelial dysfunction compared to patients without diabetes.