Leptin and its associations with complications of acute myocardial infarction in patients with the metabolic syndrome
Kamila Kholmatova1,2, Irina Dvoryashina1 & Tatyana Supryadkina2
Background: Increased leptin levels are revealed in obese patients and known to predict the development of the ischemic heart disease, but the information about leptins effects on the course of the acute myocardial infarction (AMI) in patients with the metabolic syndrome (MetS) is scarce.
Aim: To assess plasma leptin levels in patients with AMI and MetS and to study the relationships between leptin and early complications of AMI.
Methods: Fifty-nine subjects (84.5% of men, mean age 56.7±9.0 years) with ST-segment elevation AMI without diabetes mellitus were included. According to the IDF criteria 39 patients had MetS. Group differences in patients clinical and anthropometrical data, blood level of fasting and postprandial glucose and insulin during oral glucose tolerance test, held after patients condition stabilization, leptin, lipids, C-reactive protein, and echocardiography data were analyzed by MannWhitney and χ2 tests. Associations of leptin with occurrence of the complications during AMI in-hospital period were studied by logistic regression analysis.
Results: Patients with MetS had significantly higher levels of leptin (120.57, 75.89162.00 vs 44.24, 19.1676.51 ng/ml; P<0.001), postpload glucose (8.10, 6.309.50 vs 6.35, 5.176.75 mmol/l; P=0.002), basal insulin (11.85, 9.5420.81 vs 6.74, 5.5610.26 microIU/ml; P<0.001), systolic blood pressure (SBP) on admission (140.00, 130.00160.00 vs 107.50, 90.00140.00 mmHg; P=0.049), while there were now differences in gender (0.132), age (P=0.450), basal glucose (P=0.678), stimulated insulin (P=0.062), stimulated/basal insulin ratio (0.885), and C-reactive protein (P=0.981). There were no statistically significant associations between leptin and any of in-hospital complications of AMI in all patients, including cardiogenic shock (OR=0.98; 95% CI=0.961.01, P=0.197), congestive heart failure (OR=1.01; 95% CI=0.991.01, P=0.577), and low left ventricular ejection fraction (OR=1.01; 95% CI=0.991.01, P=0.966).
Conclusion: Although basal leptin and insulin levels and SBP are abnormally high in patients with AMI and MetS, leptin is not associated with the early prognosis after AMI.