Features of Amino Acid Composition of Blood in Post-Infarction Patients with Impaired Carbohydrate Exchange and Its Interconnection with Cardiovascular Risk Factors

Abstract

Amino acids (AA) are important predictors of ischemic changes in the myocardium and insulin resistance. The purpose of this study is to learn serum AA in patients withpostinfarction cardiosclerosis (PICS) in combination with diabetes mellitus type 2 (DM) and without impaired carbohydrate metabolism, as well as the relationship of AA with indicators of carbohydrate and lipid metabolism as cardiovascular risk (CVR) factors, which may allow using AA as predictors of cardiovascularcomplications. 31 patients with PICS and concomitant DM were selected for the study, which formed the main group (MG). The comparison group (CG) included 27 patients with PICS without DM. Patients with PICS and DM showed a statistically significant increase in the total concentration of AA compared with the CG – by 24.91% (p<0.05) andin the concentration of branched-chain amino acids (BCA) -isoleucine -by 28,39%, leucine-by 41.11% (p<0.001), valine – by 34.1% (p<0.05); lysine concentration – by 11.8% (p<0.05), aspartate – by 17.3% (p <0.001), glutamate – by 11.4% (p<0.05). In patients of the MG there was a significant decrease in the concentration of taurine, arginine, methionine, glycine: by 11.3% (p<0.05), 18,1% (p<0.05), 7.7% (p<0.001), 10.12% (p<0.001), respectively, compared with patients with PICS without impaired carbohydrate metabolism. According to the results of this analysis, the average strength of the inverse correlations of AA with the parameters of lipid metabolism: between taurine and very low-density cholesterol (VLDL) (r= -0.54; p<0.05), total cholesterol (r=-0.52; p>0.05);between methionine and VLDL (r =-0.62; p<0.05) and ApoB/ApoA1 (r = -0.59; p<0.05).The average strength of the correlation of AA with carbohydrate metabolism was also established: inverse – Tau with HbA1c (r = -0.55; p <0.05), HOMA index (r=-0.45; p<0.05), insulin (r=-0.41; p<0.05);methionine with HOMA index (r=-0.62; p<0.05), and insulin (r=-0.55; p<0.05).Direct correlations of medium strength were found for ARL and Ala (r=0.56 and r=0.55; p <0.05). The presence of correlations between CVR indicators and the content of individual blood AAs suggests the possibility of using AAs as prognostic markers of fatal cardiovascular events and requires further research.