Keywords
cardiorenal metabolic syndrome
coronary heart disease
insulin resistance indices
heart geometry
liver steatosis
How to Cite
Abstract
In press
Background. The renal function influence on the course of cardiac pathology has not been sufficiently described in the presence or absence of Insulin Resistance (IR).
Aim. To assess the renal functional impact as stages of cardiorenal metabolic syndrome on clinical and laboratory characteristics in the presence of insulin resistance.
Materials and Methods. 86 patients with acute forms of coronary artery disease were examined. According HOMA-IR they were divided into group A without IR (n=26) and group B with IR (n=60). Groups were divided according glomerular filtration rate into 1st (G1A and G1B) and 2nd (G2A and G2B) stages of Cardiorenal Metabolic Syndrome (CRMS). A glucose tolerance test was performed with checking of insulin and C-protein. Glycated hemoglobin and trygliceride glucose index (TGI) were checked too. The IR indices (QUICKI; %S; McAuley; Gutt; Cederholm; Matsuda; Avignon; Shuster; DI DeFronzo; Drivsholm; Stumvoll early and late; Philips; Wareham) were calculated. The results were processed using the Statistica 6.0 (Statsoft, USA). Data are presented as Mean ± Standard Error (M±SE). Correlation analysis was performed using the Spearman and Pearson methods, differences analyzed with the t-criterion. The significance of glucose and insulin levels was verified using ROC analysis. The study was conducted within the framework of a research topic with state registration number 0122U00016 (2022–2026).
Research Ethics. The study was conducted in accordance with the World Medical Association Declaration of Helsinki (1964–2024), approved by the Bioethics Committee of University (Protocol No.2 of February 21, 2022). All participants provided informed consent to participate.
Results. An increase of both indexed values of left ventricular myocardial mass (according body surface area and height) and indexed diastolic left ventricular size was observed regardless of the presence of IR but in the conditions of higher stage of CRMS. In patients with stage 1 of CRMS, insulin resistance was accompanied by higher values of TGI, triglycerids to high density lipoprotein ratio, and activity of inflammation. Deteriorations of renal function and IR were accompanied by lower peripheral tissues sensitivity to insulin, decreased hemoglobin, activation of inflammation, steatotic liver degeneration according to alaninaminotransferase level, and changes in the heart with wall hypertrophy.
Conclusions. Cardiorenal metabolic syndrome stage increasing and insulin resistance were accompanied by changes in the heart and liver.
Keywords: cardiology, cardiorenal metabolic syndrome, coronary heart disease, insulin resistance indices, heart geometry, liver steatosis.
References
Muniyappa R, Madan R, Varghese RT. Assessing Insulin Sensitivity and Resistance in Humans. 2024 Oct 16. In: Feingold KR, Adler RA, Ahmed SF, Anawalt B, Blackman MR, Chrousos G, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000. PMID: 25905189.
Dong B, Chen Y, Yang X, Chen Z, Zhang H, Gao Y, et al. Estimated glucose disposal rate outperforms other insulin resistance surrogates in predicting incident cardiovascular diseases in cardiovascular-kidney-metabolic syndrome stages 0–3 and the development of a machine learning prediction model: a nationwide prospective cohort study. Cardiovasc Diabetol. 2025;24(1):163. DOI: 10.1186/s12933-025-02729-1. PMID: 40241176.
Sundström J, Bodegard J, Bollmann A, Vervloet MG, Mark PB, Karasik A, et al.; CaReMe CKD Investigators. Prevalence, outcomes, and cost of chronic kidney disease in a contemporary population of 2,4 million patients from 11 countries: The CaReMe CKD study. Lancet Reg Health Eur. 2022;20:100438. DOI: 10.1016/j.lanepe.2022.100438. PMID: 36090671.
Ndumele CE, Neeland IJ, Tuttle KR, Chow SL, Mathew RO, Khan SS, et al. American Heart Association. A Synopsis of the Evidence for the Science and Clinical Management of Cardiovascular-Kidney-Metabolic (CKM) Syndrome: A Scientific Statement from the American Heart Association. Circulation. 2023;148(20):1636-64. DOI: 10.1161/CIR.0000000000001186. PMID: 37807920.
Li W, Shen C, Kong W, Zhou X, Fan H, Zhang Y, et al. Association between the triglyceride glucose-body mass index and future cardiovascular disease risk in a population with Cardiovascular-Kidney-Metabolic syndrome stage 0-3: a nationwide prospective cohort study. Cardiovasc Diabetol. 2024;23(1):292. DOI: 10.1186/s12933-024-02352-6. PMID: 39113004.
Park SY, Gautier JF, Chon S. Assessment of Insulin Secretion and Insulin Resistance in Human. Diabetes Metab J. 2021; 45(5):641-54. DOI: 10.4093/dmj.2021.0220. PMID: 34610719.
Huanan C, Sangsang L, Amoah AN, Yacong B, Xuejiao C, Zhan S, et al. Relationship between triglyceride glucose index and the incidence of non-alcoholic fatty liver disease in the elderly: a retrospective cohort study in China. BMJ Open. 2020;10(11):e039804. DOI: 10.1136/bmjopen-2020-039804. PMID: 33247011.
Kittelson KS, Junior AG, Fillmore N, da Silva Gomes R. Cardiovascular-kidney-metabolic syndrome – An integrative review. Prog Cardiovasc Dis. 2024;87:26-36. DOI: 10.1016/j.pcad.2024.10.012. PMID: 39486671.
Xu X, Shao X, Hou FF. Risk stratification of metabolic disorder-associated kidney disease. Kidney Int. 2025;107(6):1002-10. DOI: 10.1016/j.kint.2025.01.041. PMID: 40157500.
Lay AC, Tran VDT, Nair V, Betin V, Hurcombe JA, Barrington AF, et al.BEAt-DKD consortium. Profiling of insulin-resistant kidney models and human biopsies reveals common and cell-type-specific mechanisms underpinning Diabetic Kidney Disease. Nat Commun. 2024;15(1):10018. DOI: 10.1038/s41467-024-54089-1. PMID: 39562547.
Liu Q, An XF, Li L, Zhang H, Zuo YQ. Relationships Between Insulin Resistance Surrogate Indicators and Chronic Kidney Disease in Non-Diabetic Individuals: A Retrospective Cross-Sectional Study.Diabetes MetabSyndrObes. 2025;18:1967-76. DOI:10.2147/DMSO.S527662.
Scurt FG, Ganz MJ, Herzog C, Bose K, Mertens PR, Chatzikyrkou C. Association of metabolic syndrome and chronic kidney disease. Obes Rev. 2024;25(1):e13649. DOI: 10.1111/obr.13649. PMID: 37783465.
Duan M, Zhao X, Li S, Miao G, Bai L, Zhang Q, et al. Metabolic score for insulin resistance (METS-IR) predicts all-cause and cardiovascular mortality in the general population: evidence from NHANES 2001-2018. Cardiovasc Diabetol. 2024;23(1):243. DOI: 10.1186/s12933-024-02334-8. PMID: 38987779.
Theodorakis N, Nikolaou M. From Cardiovascular-Kidney-Metabolic Syndrome to Cardiovascular-Renal-Hepatic-Metabolic Syndrome: Proposing an Expanded Framework. Biomolecules. 2025;15(2):213. DOI: 10.3390/biom15020213. PMID: 40001516.
Komarytsia О, Radchenko О, Borovets М, Strilchuk L, Stadnik S. Changes in the cytokine profile in patients with a combination of type 2 diabetes mellitus, hypertension, coronary heart disease and hepatic steatosis under conditions of obesity. Rom J Diabetes NutrMetab Dis. 2023;30(4):460-5. Available at: https://www.rjdnmd.org/index.php/RJDNMD/article/view/1373
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