Cytokines of proinflammatory action and viscoelasticity of vascular walls among diabetes (II type) patients

Chernenok V.V., Shulginova A.A., Knyazeva L.A., Goryaynov I.I., Belchenknova K.A.
Kursk State Medical University
Internal diseases department №1 (head of department, Doctor of Medicine, Professor Knyazeva L.I.)

Diabetes is an actual medical and social problem causing high level of invalidization of ill people what results in progressive damage of vascular bed.
Some authors points at close interrelation between pathological changes connected with mechanical properties of arterial walls and occurrence of cardiovascular complications. 
The role of immune inflammation in atherosclerosis advance is to be mentioned. Herewith the character of immunological status indices and their interrelation with vascular stiffness among patients with diabetes II type is a poorly studied subject what embarrasses development of methods for the current pathology therapy optimization.

Purpose: Study interrelation between cytokines of proinflammatory action and indices of vascular beds stiffness among diabetes (II type) patients.

Materials and methods: 83 patients with diabetes of medium illness severity were included in the research, 48 female and 35 male 38-55 years old, the average age was 45,5 ± 4,8 years. Patients were randomized into 2 groups (43 diabetes (II type) patients with disease period less than 5 years and 40 patients with disease period more than 5 years). Patients at diabetes compensation stage were also included in the research. Control group consisted of 30 healthy donors.
Content of FNOα, IL-1β, IL-6 in blood serum was defined by a method of enzyme-linked immunosorbent assay (Pro Con, Saint-Petersburg).
Vascular walls parameters were estimated with the use of ambulatory blood pressure monitor manufactured by “Petr Telegin” company (Nizhny Novgorod).
The following indices were defined:
PTT (sm/sec) – pulse transit time, dP/dt – maximum rate of pressure rise (mmHg/sec), ASI – arterial stiffness index, AIx – augmentation index (%), Ssys – stroke systolic area index (%). 
Statistical data were processed with the use of standard software package Microsoft Excel and STATISITICA 5.0 for Windows.
Results of serumal cytokines level definition in the group of the inspected patients showed that diabetes patients experienced reliable concentration increase of FNOα (266,4 ± 36,1 pg/ml), IL-1β (206,8 ± 23,5 pg/ml); IL-6 (79,8 ± 9,7) in comparison with control group.
In case of continued disease period (more than 5 years) an advanced proinflammatory cytokinemia was detected. The content of FNOα in this patients group was 17,3%, IL-1β - 14,9%, IL-6  - 12,5%, IL-8 - 32,4%, INF-γ - 14,3 % higher than among patients with case history under 5 years which is determined by spreading of vascular beds damage in this patients group.
Inverse correlation is detected by level of proinflammatory cytokines of FNOα, IL-1β, IL-6 and PTT (r= - 0,74, p<0,01 and r = - 0,58, p<0,05; r = - 0,79, p<0,01); direct dependence is detected between the present cytokines and PTT (r=0,46, p<0,01; r = 0,65, p<0,05 and r = 0,53, p<0,05) and ASI (r=-0,61, p<0,01, r=0,57, p<0,05, r=-0,71, p<0,01) accordingly.
All diabetes patients were diagnosed a decrease of vascular walls elasticity in comparison with control group. So PTT was reliably shorter (38% shorter, p<0,01) in comparison with control group (102,7 ± 1,6 msec and 165,2 ± 1,8 msec accordingly). Maximum speed of blood pressure rise dP/dtmax indirectly reflecting vascular load at PTT was reduced by 1,87 times (at p<0,01) among patients with diabetes period more than 5 years in comparison with the control group. ASI was 54,2 ±  1,7 what exceed control values by 46% (p<0,01) and by 22,3% among patients with diabetes period under 5 years.
Augmentation index (AIx) of patients with disease (II type) period more than 5 years was 4 times higher than control group index (-30 ± 2,1%, p<0,01).
PWDT was 187,4 ± 1,2 sm/sec what exceeded control group value (137,8 ± 1,3 sm/sec) by 36% and by 15% if diabetes period was under 5 years.
The present changes testify decrease of vascular viscoelasticity advancing with the disease period among diabetes (II type) patients.