Interaction between inflammatory biomarkers and carbohydrate and lipid metabolism in patients with diabetes mellitus and chronic heart failure with moderately reduced ejection fraction

The purpose — to study the association of lipoprotein-associated phospholipase A2 (LP-PLA2) inflammatory biomarkers and tumor necrosis factor-alpha (TNF-α) with indicators of carbohydrate and lipid metabolism in the progression of chronic heart failure with moderately reduced ejection fraction (HFmrEF) in patients with diabetes mellitus (DM). Material and methods. 78 patients with established diagnosis of DM and HFmrEF (EF = 41–49%), functional class (FC) of CHF I and II according to NYHA were examined. The patients underwent examination of carbohydrate and lipid metabolism, serum levels of LP-PLA2 and TNF-a. Two groups of patients were formed: the 1st group — patients with HFmrEF and DM who had myocardial infarction (MI), 37 people (47.4%), the 2nd group — patients with HFmrEFand DM, 41 people (52.6%). Results. An increase in the content of LP-PLA2 and TNF-a with an increase in CHF FC was revealed. In the 1st group, the levels of inflammation biomarkers, insulin, HOMA-IR, total cholesterol, low density lipoproteins significantly exceeded those in the 2nd group. A positive correlation was found between the levels of LP-PLA2 and TNF-a and the parameters of carbohydrate and lipid metabolism. Conclusion. The progression of DM and HFmrEF is accompanied by an increase in chronic inflammation and an increase in the content of Lp-PLA2 and TNF-a with an increase in CHF FC. The association of elevated levels of inflammatory biomarkers with carbohydrate and lipid metabolism is an additional factor of HFmrEF progression in patients with DM. An increase in the serum levels of inflammatory biomarkers in patients with HFmrEF and DM who underwent MI, compared with patients with HFmrEF and DM, makes it possible to use LP-PLA2 and TNF-a for diagnosing complications in patients with DM and HFmrEF.