Circulating endothelial-derived apoptotic microparticles and insulin resistance in non-diabetic patients with chronic heart failure

• Published in: Clinical chemistry and laboratory medicine Vol. 54; no. 7; pp. 1259 - 1267
• Main Authors: Berezin, Alexander E., Kremzer, Alexander A., Cammarota, Giovanni, Zulli, Anthony, Petrovic, Daniel, Martell-Claros, Nieves, Sabo, Jan, Kruzliak, Peter
• Format: Journal Article
• Language: English
• Published: Germany De Gruyter 01.07.2016
• Subjects: apoptotic endothelial-derived microparticles; Biomarkers - blood; Cell-Derived Microparticles - pathology; Chronic Disease; chronic heart failure; Coronary Angiography; Endothelial Progenitor Cells - pathology; Female; Glomerular Filtration Rate; Heart Failure - blood; Heart Failure - physiopathology; Humans; Insulin Resistance; Male; Middle Aged; Phenotype; Severity of Illness Index
• ISSN: 1434-6621; 1437-4331
• DOI: 10.1515/cclm-2015-0605

The objective of this study was to assess the relationship between insulin resistance and apoptotic endothelial-derived microparticles (EMPs) in patients with chronic heart failure (CHF). The study involved 300 CHF patients (186 males) aged 48–62 years with angiographically proven coronary artery disease and/or previously defined myocardial infarction. Insulin resistance was assessed by the homeostasis model assessment for insulin resistance (HOMA-IR). EMPs phenotype was determined by flow cytofluorometry. Depending on HOMA-IR cut-off point (over and <2.77 mmol/L×μU/mL) all patients were divided into two cohorts with (n=171) or without (n=129) IR, respectively. Circulating EMPs were higher in CHF patients with IR than in patients without IR. Interestingly, EMPs were directly related to NYHA functional class of CHF, HOMA-IR, NT-pro-BNP, hs-CRP and BMI. There was a significant association between the level of EMPs and HbA , gender (r=0.318, p<0.001 for male), age and smoking. On univariate and multivariate regression analysis we found that the NYHA class of CHF,NT-pro-BNP, hs-CRP, and left ventricular ejection fraction (LVEF) appeared to be independent predictors of increased circulatory apoptotic EMPs. The addition of HOMA-IR to the standard model (NYHA class CHF) improved the relative IDI by 19.9% for increased EMPs. For category-free NRI, 10% of events and 24% of non-events were correctly reclassified by the addition of HOMA-IR to the standard model for increased circulating EMPs. IR may be a contributing factor increasing circulating levels of apoptotic EMPs in non-diabetic CHF patients.