Skip to main content
Top
Published in: Cardiovascular Diabetology 1/2010

Open Access 01-12-2010 | Original investigation

Increased levels of CRP and MCP-1 are associated with previously unknown abnormal glucose regulation in patients with acute STEMI: a cohort study

Authors: Eva C Knudsen, Ingebjørg Seljeflot, Abdelnoor Michael, Jan Eritsland, Arild Mangschau, Carl Müller, Harald Arnesen, Geir Ø Andersen

Published in: Cardiovascular Diabetology | Issue 1/2010

Login to get access

Abstract

Background

Inflammation plays an important role in the pathophysiology of both atherosclerosis and type 2 diabetes and some inflammatory markers may also predict the risk of developing type 2 diabetes. The aims of the present study were to assess a potential association between circulating levels of inflammatory markers and hyperglycaemia measured during an acute ST-elevation myocardial infarction (STEMI) in patients without known diabetes, and to determine whether circulating levels of inflammatory markers measured early after an acute STEMI, were associated with the presence of abnormal glucose regulation classified by an oral glucose tolerance test (OGTT) at three-month follow-up in the same cohort.

Methods

Inflammatory markers were measured in fasting blood samples from 201 stable patients at a median time of 16.5 hours after a primary percutanous coronary intervention (PCI). Three months later the patients performed a standardised OGTT. The term abnormal glucose regulation was defined as the sum of the three pathological glucose categories classified according to the WHO criteria (patients with abnormal glucose regulation, n = 50).

Results

No association was found between inflammatory markers and hyperglycaemia measured during the acute STEMI. However, the levels of C-reactive protein (CRP) and monocyte chemoattractant protein-1 (MCP-1) measured in-hospital were higher in patients classified three months later as having abnormal compared to normal glucose regulation (p = 0.031 and p = 0.016, respectively). High levels of CRP (≥ 75 percentiles (33.13 mg/L)) and MCP-1 (≥ 25 percentiles (190 ug/mL)) were associated with abnormal glucose regulation with an adjusted OR of 3.2 (95% CI 1.5, 6.8) and 7.6 (95% CI 1.7, 34.2), respectively.

Conclusion

Elevated levels of CRP and MCP-1 measured in patients early after an acute STEMI were associated with abnormal glucose regulation classified by an OGTT at three-month follow-up. No significant associations were observed between inflammatory markers and hyperglycaemia measured during the acute STEMI.
Appendix
Available only for authorised users
Literature
1.
go back to reference Norhammar A, Tenerz A, Nilsson G, Hamsten A, Efendic S, Ryden L, Malmberg K: Glucose metabolism in patients with acute myocardial infarction and no previous diagnosis of diabetes mellitus: a prospective study. Lancet. 2002, 359: 2140-2144. 10.1016/S0140-6736(02)09089-X.CrossRefPubMed Norhammar A, Tenerz A, Nilsson G, Hamsten A, Efendic S, Ryden L, Malmberg K: Glucose metabolism in patients with acute myocardial infarction and no previous diagnosis of diabetes mellitus: a prospective study. Lancet. 2002, 359: 2140-2144. 10.1016/S0140-6736(02)09089-X.CrossRefPubMed
2.
go back to reference Bartnik M, Malmberg K, Norhammar A, Tenerz A, Ohrvik J, Ryden L: Newly detected abnormal glucose tolerance: an important predictor of long-term outcome after myocardial infarction. Eur Heart J. 2004, 25: 1990-1997. 10.1016/j.ehj.2004.09.021.CrossRefPubMed Bartnik M, Malmberg K, Norhammar A, Tenerz A, Ohrvik J, Ryden L: Newly detected abnormal glucose tolerance: an important predictor of long-term outcome after myocardial infarction. Eur Heart J. 2004, 25: 1990-1997. 10.1016/j.ehj.2004.09.021.CrossRefPubMed
3.
go back to reference Ryden L, Standl E, Bartnik M, Van den BG, Betteridge J, de Boer MJ, Cosentino F, Jonsson B, Laakso M, Malmberg K, Priori S, Ostergren J, Tuomilehto J, Thrainsdottir I, Vanhorebeek I, Stramba-Badiale M, Lindgren P, Qiao Q, Priori SG, Blanc JJ, Budaj A, Camm J, Dean V, Deckers J, Dickstein K, Lekakis J, McGregor K, Metra M, Morais J, Osterspey A, Tamargo J, Zamorano JL, Deckers JW, Bertrand M, Charbonnel B, Erdmann E, Ferrannini E, Flyvbjerg A, Gohlke H, Juanatey JR, Graham I, Monteiro PF, Parhofer K, Pyorala K, Raz I, Schernthaner G, Volpe M, Wood D: Guidelines on diabetes, pre-diabetes, and cardiovascular diseases: executive summary. The Task Force on Diabetes and Cardiovascular Diseases of the European Society of Cardiology (ESC) and of the European Association for the Study of Diabetes (EASD). Eur Heart J. 2007, 28: 88-136. 10.1093/eurheartj/ehm124.CrossRefPubMed Ryden L, Standl E, Bartnik M, Van den BG, Betteridge J, de Boer MJ, Cosentino F, Jonsson B, Laakso M, Malmberg K, Priori S, Ostergren J, Tuomilehto J, Thrainsdottir I, Vanhorebeek I, Stramba-Badiale M, Lindgren P, Qiao Q, Priori SG, Blanc JJ, Budaj A, Camm J, Dean V, Deckers J, Dickstein K, Lekakis J, McGregor K, Metra M, Morais J, Osterspey A, Tamargo J, Zamorano JL, Deckers JW, Bertrand M, Charbonnel B, Erdmann E, Ferrannini E, Flyvbjerg A, Gohlke H, Juanatey JR, Graham I, Monteiro PF, Parhofer K, Pyorala K, Raz I, Schernthaner G, Volpe M, Wood D: Guidelines on diabetes, pre-diabetes, and cardiovascular diseases: executive summary. The Task Force on Diabetes and Cardiovascular Diseases of the European Society of Cardiology (ESC) and of the European Association for the Study of Diabetes (EASD). Eur Heart J. 2007, 28: 88-136. 10.1093/eurheartj/ehm124.CrossRefPubMed
4.
go back to reference Knudsen EC, Seljeflot I, Abdelnoor M, Eritsland J, Mangschau A, Arnesen H, Andersen GO: Abnormal glucose regulation in patients with acute ST- elevation myocardial infarction-a cohort study on 224 patients. Cardiovasc Diabetol. 2009, 8: 6-10.1186/1475-2840-8-6.PubMedCentralCrossRefPubMed Knudsen EC, Seljeflot I, Abdelnoor M, Eritsland J, Mangschau A, Arnesen H, Andersen GO: Abnormal glucose regulation in patients with acute ST- elevation myocardial infarction-a cohort study on 224 patients. Cardiovasc Diabetol. 2009, 8: 6-10.1186/1475-2840-8-6.PubMedCentralCrossRefPubMed
5.
go back to reference Libby P: Inflammation and cardiovascular disease mechanisms. Am J Clin Nutr. 2006, 83: 456S-460S.PubMed Libby P: Inflammation and cardiovascular disease mechanisms. Am J Clin Nutr. 2006, 83: 456S-460S.PubMed
6.
go back to reference Beckman JA, Creager MA, Libby P: Diabetes and atherosclerosis: epidemiology, pathophysiology, and management. JAMA. 2002, 287: 2570-2581. 10.1001/jama.287.19.2570.CrossRefPubMed Beckman JA, Creager MA, Libby P: Diabetes and atherosclerosis: epidemiology, pathophysiology, and management. JAMA. 2002, 287: 2570-2581. 10.1001/jama.287.19.2570.CrossRefPubMed
7.
go back to reference Freeman DJ, Norrie J, Caslake MJ, Gaw A, Ford I, Lowe GD, O'Reilly DS, Packard CJ, Sattar N: C-reactive protein is an independent predictor of risk for the development of diabetes in the West of Scotland Coronary Prevention Study. Diabetes. 2002, 51: 1596-1600. 10.2337/diabetes.51.5.1596.CrossRefPubMed Freeman DJ, Norrie J, Caslake MJ, Gaw A, Ford I, Lowe GD, O'Reilly DS, Packard CJ, Sattar N: C-reactive protein is an independent predictor of risk for the development of diabetes in the West of Scotland Coronary Prevention Study. Diabetes. 2002, 51: 1596-1600. 10.2337/diabetes.51.5.1596.CrossRefPubMed
8.
go back to reference Ziegler D: Type 2 diabetes as an inflammatory cardiovascular disorder. Curr Mol Med. 2005, 5: 309-322. 10.2174/1566524053766095.CrossRefPubMed Ziegler D: Type 2 diabetes as an inflammatory cardiovascular disorder. Curr Mol Med. 2005, 5: 309-322. 10.2174/1566524053766095.CrossRefPubMed
11.
go back to reference Gibbons RJ, Miller TD, Christian TF: Infarct size measured by single photon emission computed tomographic imaging with (99 m)Tc-sestamibi: A measure of the efficacy of therapy in acute myocardial infarction. Circulation. 2000, 101: 101-108.CrossRefPubMed Gibbons RJ, Miller TD, Christian TF: Infarct size measured by single photon emission computed tomographic imaging with (99 m)Tc-sestamibi: A measure of the efficacy of therapy in acute myocardial infarction. Circulation. 2000, 101: 101-108.CrossRefPubMed
12.
go back to reference Kleinbaum DG, Kupper LL, Morgenstern H: Epidemiologic research. Principles and quantitative methods. 1982, New York: Van Nostrand Reinhold Company Inc Kleinbaum DG, Kupper LL, Morgenstern H: Epidemiologic research. Principles and quantitative methods. 1982, New York: Van Nostrand Reinhold Company Inc
13.
go back to reference von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP: The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet. 2007, 370: 1453-1457. 10.1016/S0140-6736(07)61602-X.CrossRefPubMed von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP: The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet. 2007, 370: 1453-1457. 10.1016/S0140-6736(07)61602-X.CrossRefPubMed
14.
go back to reference Esposito K, Nappo F, Marfella R, Giugliano G, Giugliano F, Ciotola M, Quagliaro L, Ceriello A, Giugliano D: Inflammatory cytokine concentrations are acutely increased by hyperglycemia in humans: role of oxidative stress. Circulation. 2002, 106: 2067-2072. 10.1161/01.CIR.0000034509.14906.AE.CrossRefPubMed Esposito K, Nappo F, Marfella R, Giugliano G, Giugliano F, Ciotola M, Quagliaro L, Ceriello A, Giugliano D: Inflammatory cytokine concentrations are acutely increased by hyperglycemia in humans: role of oxidative stress. Circulation. 2002, 106: 2067-2072. 10.1161/01.CIR.0000034509.14906.AE.CrossRefPubMed
15.
go back to reference Norhammar AM, Ryden L, Malmberg K: Admission plasma glucose. Independent risk factor for long-term prognosis after myocardial infarction even in nondiabetic patients. Diabetes Care. 1999, 22: 1827-1831. 10.2337/diacare.22.11.1827.CrossRefPubMed Norhammar AM, Ryden L, Malmberg K: Admission plasma glucose. Independent risk factor for long-term prognosis after myocardial infarction even in nondiabetic patients. Diabetes Care. 1999, 22: 1827-1831. 10.2337/diacare.22.11.1827.CrossRefPubMed
16.
go back to reference Gasior M, Pres D, Stasik-Pres G, Lech P, Gierlotka M, Hawranek M, Wilczek K, Szygula-Jurkiewicz B, Lekston A, Kalarus Z, Strojek K, Gumprecht J, Polonski L: Effect of blood glucose levels on prognosis in acute myocardial infarction in patients with and without diabetes, undergoing percutaneous coronary intervention. Cardiol J. 2008, 15: 422-430.PubMed Gasior M, Pres D, Stasik-Pres G, Lech P, Gierlotka M, Hawranek M, Wilczek K, Szygula-Jurkiewicz B, Lekston A, Kalarus Z, Strojek K, Gumprecht J, Polonski L: Effect of blood glucose levels on prognosis in acute myocardial infarction in patients with and without diabetes, undergoing percutaneous coronary intervention. Cardiol J. 2008, 15: 422-430.PubMed
17.
go back to reference Capes SE, Hunt D, Malmberg K, Gerstein HC: Stress hyperglycaemia and increased risk of death after myocardial infarction in patients with and without diabetes: a systematic overview. Lancet. 2000, 355: 773-778. 10.1016/S0140-6736(99)08415-9.CrossRefPubMed Capes SE, Hunt D, Malmberg K, Gerstein HC: Stress hyperglycaemia and increased risk of death after myocardial infarction in patients with and without diabetes: a systematic overview. Lancet. 2000, 355: 773-778. 10.1016/S0140-6736(99)08415-9.CrossRefPubMed
18.
go back to reference Solheim S, Grogaard HK, Hoffmann P, Arnesen H, Seljeflot I: Inflammatory responses after percutaneous coronary intervention in patients with acute myocardial infarction or stable angina pectoris. Scand J Clin Lab Invest. 2008, 68: 555-562. 10.1080/00365510701884584.CrossRefPubMed Solheim S, Grogaard HK, Hoffmann P, Arnesen H, Seljeflot I: Inflammatory responses after percutaneous coronary intervention in patients with acute myocardial infarction or stable angina pectoris. Scand J Clin Lab Invest. 2008, 68: 555-562. 10.1080/00365510701884584.CrossRefPubMed
19.
go back to reference Karpinski L, Plaksej R, Derzhko R, Orda A, Witkowska M: Serum levels of interleukin-6, interleukin-10 and C-reactive protein in patients with myocardial infarction treated with primary angioplasty during a 6-month follow-up. Pol Arch Med Wewn. 2009, 119: 115-121.PubMed Karpinski L, Plaksej R, Derzhko R, Orda A, Witkowska M: Serum levels of interleukin-6, interleukin-10 and C-reactive protein in patients with myocardial infarction treated with primary angioplasty during a 6-month follow-up. Pol Arch Med Wewn. 2009, 119: 115-121.PubMed
20.
go back to reference strom-Olsson K, Hedstrom E, Hulten LM, Wiklund O, Arheden H, Ohlin AK, Gottsater A, Ohlin H: Dissociation of the Inflammatory Reaction following PCI for Acute Myocardial Infarction. J Invasive Cardiol. 2007, 19: 452-456. strom-Olsson K, Hedstrom E, Hulten LM, Wiklund O, Arheden H, Ohlin AK, Gottsater A, Ohlin H: Dissociation of the Inflammatory Reaction following PCI for Acute Myocardial Infarction. J Invasive Cardiol. 2007, 19: 452-456.
21.
go back to reference Pradhan AD, Manson JE, Rifai N, Buring JE, Ridker PM: C-reactive protein, interleukin 6, and risk of developing type 2 diabetes mellitus. JAMA. 2001, 286: 327-334. 10.1001/jama.286.3.327.CrossRefPubMed Pradhan AD, Manson JE, Rifai N, Buring JE, Ridker PM: C-reactive protein, interleukin 6, and risk of developing type 2 diabetes mellitus. JAMA. 2001, 286: 327-334. 10.1001/jama.286.3.327.CrossRefPubMed
22.
go back to reference Matsumori A, Furukawa Y, Hashimoto T, Yoshida A, Ono K, Shioi T, Okada M, Iwasaki A, Nishio R, Matsushima K, Sasayama S: Plasma levels of the monocyte chemotactic and activating factor/monocyte chemoattractant protein-1 are elevated in patients with acute myocardial infarction. J Mol Cell Cardiol. 1997, 29: 419-423. 10.1006/jmcc.1996.0285.CrossRefPubMed Matsumori A, Furukawa Y, Hashimoto T, Yoshida A, Ono K, Shioi T, Okada M, Iwasaki A, Nishio R, Matsushima K, Sasayama S: Plasma levels of the monocyte chemotactic and activating factor/monocyte chemoattractant protein-1 are elevated in patients with acute myocardial infarction. J Mol Cell Cardiol. 1997, 29: 419-423. 10.1006/jmcc.1996.0285.CrossRefPubMed
23.
go back to reference Mine S, Okada Y, Tanikawa T, Kawahara C, Tabata T, Tanaka Y: Increased expression levels of monocyte CCR2 and monocyte chemoattractant protein-1 in patients with diabetes mellitus. Biochem Biophys Res Commun. 2006, 344: 780-785. 10.1016/j.bbrc.2006.03.197.CrossRefPubMed Mine S, Okada Y, Tanikawa T, Kawahara C, Tabata T, Tanaka Y: Increased expression levels of monocyte CCR2 and monocyte chemoattractant protein-1 in patients with diabetes mellitus. Biochem Biophys Res Commun. 2006, 344: 780-785. 10.1016/j.bbrc.2006.03.197.CrossRefPubMed
24.
go back to reference Dragomir E, Simionescu M: Monocyte chemoattractant protein-1--a major contributor to the inflammatory process associated with diabetes. Arch Physiol Biochem. 2006, 112: 239-244. 10.1080/13813450601094672.CrossRefPubMed Dragomir E, Simionescu M: Monocyte chemoattractant protein-1--a major contributor to the inflammatory process associated with diabetes. Arch Physiol Biochem. 2006, 112: 239-244. 10.1080/13813450601094672.CrossRefPubMed
25.
go back to reference Park KS, Ahn KJ, Kim BJ, Kim HJ, Yoo SM, Kim JY, Lee KH, Baik HW, Lee SK: Circulating concentrations of monocyte chemoattractant protein-1 are associated with menopause status in Korean women. Clin Chim Acta. 2009, 403: 92-96. 10.1016/j.cca.2009.01.025.CrossRefPubMed Park KS, Ahn KJ, Kim BJ, Kim HJ, Yoo SM, Kim JY, Lee KH, Baik HW, Lee SK: Circulating concentrations of monocyte chemoattractant protein-1 are associated with menopause status in Korean women. Clin Chim Acta. 2009, 403: 92-96. 10.1016/j.cca.2009.01.025.CrossRefPubMed
26.
go back to reference Braunersreuther V, Mach F, Steffens S: The specific role of chemokines in atherosclerosis. Thromb Haemost. 2007, 97: 714-721.PubMed Braunersreuther V, Mach F, Steffens S: The specific role of chemokines in atherosclerosis. Thromb Haemost. 2007, 97: 714-721.PubMed
27.
go back to reference Straczkowski M, Kowalska I, Nikolajuk A, Dzienis-Straczkowska S, Szelachowska M, Kinalska I: Plasma interleukin 8 concentrations in obese subjects with impaired glucose tolerance. Cardiovasc Diabetol. 2003, 2: 5-10.1186/1475-2840-2-5.PubMedCentralCrossRefPubMed Straczkowski M, Kowalska I, Nikolajuk A, Dzienis-Straczkowska S, Szelachowska M, Kinalska I: Plasma interleukin 8 concentrations in obese subjects with impaired glucose tolerance. Cardiovasc Diabetol. 2003, 2: 5-10.1186/1475-2840-2-5.PubMedCentralCrossRefPubMed
28.
go back to reference Thorand B, Kolb H, Baumert J, Koenig W, Chambless L, Meisinger C, Illig T, Martin S, Herder C: Elevated levels of interleukin-18 predict the development of type 2 diabetes: results from the MONICA/KORA Augsburg Study, 1984-2002. Diabetes. 2005, 54: 2932-2938. 10.2337/diabetes.54.10.2932.CrossRefPubMed Thorand B, Kolb H, Baumert J, Koenig W, Chambless L, Meisinger C, Illig T, Martin S, Herder C: Elevated levels of interleukin-18 predict the development of type 2 diabetes: results from the MONICA/KORA Augsburg Study, 1984-2002. Diabetes. 2005, 54: 2932-2938. 10.2337/diabetes.54.10.2932.CrossRefPubMed
29.
go back to reference Derosa G, Cicero AF, Scalise F, Avanzini MA, Tinelli C, Peros E, Fogari E, D'Angelo A: Metalloproteinases in diabetics and nondiabetics during acute coronary syndromes and after 3 months. Endothelium. 2007, 14: 175-183. 10.1080/10623320601177064.CrossRefPubMed Derosa G, Cicero AF, Scalise F, Avanzini MA, Tinelli C, Peros E, Fogari E, D'Angelo A: Metalloproteinases in diabetics and nondiabetics during acute coronary syndromes and after 3 months. Endothelium. 2007, 14: 175-183. 10.1080/10623320601177064.CrossRefPubMed
30.
go back to reference Hotta K, Funahashi T, Arita Y, Takahashi M, Matsuda M, Okamoto Y, Iwahashi H, Kuriyama H, Ouchi N, Maeda K, Nishida M, Kihara S, Sakai N, Nakajima T, Hasegawa K, Muraguchi M, Ohmoto Y, Nakamura T, Yamashita S, Hanafusa T, Matsuzawa Y: Plasma concentrations of a novel, adipose-specific protein, adiponectin, in type 2 diabetic patients. Arterioscler Thromb Vasc Biol. 2000, 20: 1595-1599.CrossRefPubMed Hotta K, Funahashi T, Arita Y, Takahashi M, Matsuda M, Okamoto Y, Iwahashi H, Kuriyama H, Ouchi N, Maeda K, Nishida M, Kihara S, Sakai N, Nakajima T, Hasegawa K, Muraguchi M, Ohmoto Y, Nakamura T, Yamashita S, Hanafusa T, Matsuzawa Y: Plasma concentrations of a novel, adipose-specific protein, adiponectin, in type 2 diabetic patients. Arterioscler Thromb Vasc Biol. 2000, 20: 1595-1599.CrossRefPubMed
Metadata
Title
Increased levels of CRP and MCP-1 are associated with previously unknown abnormal glucose regulation in patients with acute STEMI: a cohort study
Authors
Eva C Knudsen
Ingebjørg Seljeflot
Abdelnoor Michael
Jan Eritsland
Arild Mangschau
Carl Müller
Harald Arnesen
Geir Ø Andersen
Publication date
01-12-2010
Publisher
BioMed Central
Published in
Cardiovascular Diabetology / Issue 1/2010
Electronic ISSN: 1475-2840
DOI
https://doi.org/10.1186/1475-2840-9-47

Other articles of this Issue 1/2010

Cardiovascular Diabetology 1/2010 Go to the issue
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.