Clinical and prognostic value of leptin resistance in the hospital period of myocardial infarction

Abstract

Aim. To evaluate the prevalence of leptin resistance (LR) and its clinical and prognostic value in association with metabolic disorders and features of the proinflammatory state in the hospital period of myocardial infarction. Materials and methods. The study included 114 men diagnosed with ST segment elevation myocardial infarction (MI). On day 1 and 12 of MI, the levels of leptin and leptin receptor were measured in patients, and the free leptin index (FLI) was calculated. Leptin resistance (LR) was recorded at leptin > 6.45 ng / ml and FLI > 25. A comparative analysis of clinical and anamnestic characteristics, biochemical parameters, and cardiovascular prognosis was carried out between patients with and without LR. Statistical data processing was carried out using the Statistica 10.0 software package and SPSS 17.0 for Windows . Results. The prevalence of LR in the hospital period of MI was 64%. LR was associated with cardiovascular pathology in the family history, arterial hypertension, dyslipidemia, and obesity. The presence of LR was accompanied by a significant increase in the level of glucose, free fatty acids (FFA), and interleukin (IL)-6 on day 1 of MI and by a significant rise in insulin, C-peptide, tumor necrosis factor (TNF)-alpha, and plasminogen activator inhibitor-1 (PAI-1) throughout the hospital stay. Patients with LR were characterized by multi-vessel and more severe lesions of the coronary bed and were more often subject to early post-infarction angina, recurrent MI, rhythm and conduction disturbances during hospital stay for MI. Conclusion. Patients with MI are characterized by high prevalence of LR during the hospital stay. LR is associated with cardiovascular risk factors, metabolic disorders, formation of insulin resistance, and increased proinflammatory and prothrombogenic factors. The identified features in the presence of LR probably contribute to the development of adverse cardiovascular events in the hospital period of MI.