Keywords
сhronic heart failure
coronary artery disease
type 2 diabetes mellitus
obesity
galectin-3
How to Cite
Abstract
In press
Background. Chronic Heart Failure (CHF) is an unfavourable pathology, the prevalence of which is increasing in patients with cardiometabolic pathology (Coronary Artery Disease (CAD), Type 2 Diabetes Mellitus (T2DM) and obesity). One of the key profibrotic biomarkers in this pathology is galectin-3, but its role in the development of dysglycaemia in comorbidity remains insufficiently studied.
Aim. To study the relationship between serum galectin-3 levels and carbohydrate metabolism indicators in patients with comorbid cardiometabolic pathology depending on the phenotype of chronic heart failure.
Materials and Methods. We examined 225 patients with CHF in CAD, divided into four groups and subgroups according to CHF phenotypes (CHF with preserved Ejection Fraction (CHFpEF); CHF with moderately reduced Ejection Fraction (CHFmEF); HF with reduced Ejection Fraction (HFrEF)). Group 1 included 75 patients with CAD, T2DM and obesity. Group 2 included 50 patients with CAD and T2DM. Group 3 included 50 patients with CAD and obesity. Group 4 included 50 patients with CAD without metabolic pathology. The control group consisted of 30 healthy individuals. Serum glucose, insulin, and glycated haemoglobin (HbA1c) levels were determined, and the HOMA-IR (Homeostasis Model Assessment of Insulin Resistance) index was calculated. The level of galectin-3 was determined by immunoenzymatic method. Statistical analysis was performed using Fisher's criterion and Spearman's coefficient (p=0.05). The work was performed as part of the author's dissertation research.
Research Ethics. The study was carried out in accordance with the norms of WMA Declaration of Helsinki (1964–2024) and approved by the Bioethics Committee of Kharkiv National Medical University. All involved patients signed an informed consent.
Results. In Groups 1 and 2, a progressive deterioration in carbohydrate metabolism and an increase in galectin-3 were found in parallel with a decrease in Left Ventricular (LV) Ejection Fraction (EF). In Group 2, the HOMA-IR index in HFpEF was 264.8% higher than in HFpEF, and galectin-3 was 95.4% higher. Strong correlations were found between galectin-3 and HOMA-IR (r=0.72; p<0.05) and glucose (r=0.64; p<0.05). In Group 3, with a decrease in LVEF, only insulin (by 98.6%) and HOMA-IR increased, while HbA1c and galectin-3 levels did not change significantly. The correlation of galectin-3 was significant only with insulin (r=0.73; p<0.05).
Conclusions. Insulin resistance progresses most sensitively with a decrease in ejection fraction in metabolic disorders. The activation of galectin-3 as a mediator of fibrosis and dysglycaemia is closely associated with type 2 diabetes mellitus. The absence of a reliable correlation between galectin-3 and heart failure phenotypes in patients without type 2 diabetes mellitus emphasises the critical role of comorbid metabolic pathology in the progression of heart failure.
Keywords: therapy, сhronic heart failure, coronary artery disease, type 2 diabetes mellitus, obesity, galectin-3.
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