A special feature of coronary heart
disease (CHD) in patients with type 2 diabetes mellitus
(T2DM) is that it is often asymptomatic and occurs as a
consequence of cardiovascular autonomic neuropathy.
Dysregulation of the autonomic nervous system is associated with elevated values of inflammatory markers such as
high-sensitivity C-reactive protein (hs-CRP) and interleukin6 (IL-6), which accelerate atherosclerosis and the occurrence of cardiovascular complications in patients with
T2DM. The aim of the study was to evaluate the importance of determining inflammatory cardiovascular risk
markers IL-6 and hs-CRP in screening for the presence of
CHD in asymptomatic patients with T2DM. Methods.
The study included 169 patients with T2DM without any
symptoms and signs of CHD. Ergometric testing proved
or ruled out the presence of silent CHD. The levels of hsCRP and IL-6 were determined by ELISA. Results. IL-6
values were significantly higher in patients with a positive
ergometric test (6.83 ± 1.99 pg/mL) compared to patients
with a negative ergometric test (3.04 ± 1.39 pg/mL)
(p < 0.001). We also found that hs-CRP values in patients
with a positive ergometric test were significantly higher
compared to patients with a negative ergometric test
(6.37 ± 2.25 vs 1.67 ± 1.41 mg/L; p < 0.001). Combinations of IL-6 and hs-CRP with age, HbA1c values, and duration of diabetes, presented through three binary logistic
regression models, are significant predictors of silent CHD
proven by ergometric testing, ie, with their increase, the
probability of a positive ergometric test also increases (p <
0.01). The sensitivity of the associated finding of elevated
IL-6 and hs-CRP values in the detection of silent CHD by
ergometric testing was 90%, and the specificity was 86%.
Conclusion. Hs-CRP and IL-6 are significant predictors
of silent CHD, and their determination could be
recommended for improving cardiovascular risk stratification in asymptomatic patients with T2DM.
