RELATIONSHIP OF RESISTIN, INTERLEUKIN 6 AND LIPID PROFILE TO THE EXTENT OF VESSEL DISEASE DETERMINED BY ANGIOGRAPHY IN DIABETES AND ISCHEMIC HEART DISEASE (IHD) PATIENTS

ABSTRACT 

Background: Studies in animals have shown that hyperresistinemia impairs glucose tolerance and induces hepatic insulin resistance in rodents, while mice deficient in resistin are protected from obesity-associated insulin resistance. Although assays for human resistin are in their infancy, but several small studies have reported that circulating resistin levels are increased in human obesity  and diabetes.

Aims: To measure serum Resistin levels, Interleukin 6 (IL6) and lipid profile in, diabetic patients and non diabetic controls, with and without ischemic heart disease.   

Methods: Patients between the ages of 50-70 years coming to angiography department for evaluation of their heart disease were divided into 2 groups i.e. patients with diabetes mellitus and those without diabetes. Each group was further divided into two groups of those having coronary heart disease and those without coronary heart disease, thus making 4 groups of patients i.e diabetes with IHD, diabetes without IHD, non diabetics with IHD and non diabetic without IHD who served as controls. The study was approved by Ethical Committee, Ziauddin University and consent was taken from each patient. Fasting blood sample was taken and serum was stored at -70 ^oC for analysis. Diabetes mellitus was diagnosed if fasting blood sugar exceeds 110mg /dl and random blood sugar > 140 mg/dl. The extent of vessel block was determined by angiography in cases having ischemic heart disease while serum Resistin and Interleukin 6 were done using ELISA and lipid profile by standard kit method. Single two vessel and three vessel occlusions were included in the study.  

Results: A total of 147 subjects were included in the study, while 13 subjects were dropped from the study due to other cardiac complications. They were divided into four groups of Non diabetic controls and diabetic patients and each group was further divided into those with coronary heart disease and those without heart disease (IHD).  The relationship of circulating resistin and interleukin 6 was checked in IHD patients with and without diabetes. High circulating levels of resitin and IL6 were seen in IHD patients with and without diabetes as compared to the controls.

Significant positive correlation was found between the resistin and interleukin-6 in patients having IHD without diabetes (r=0.66, p<0.01) and IHD with diabetes (r=0.41, p<0.05). Age and waist hip ratio of the four groups were comparable. 

The study also looked into the variation of resistin and interleukin-6 with the extent of coronary vessel disease and showed significant raise in interleukin 6 and resistin levels with the increase in number of affected vessels.

Conclusions: There was a significant increase in the levels of resistin and interleukin 6 in three vessel diseases as compared to single vessel disease.