V.I. Volkov, S.A. Serik Soluble forms of CD14 in heart failure patients with ischemic heart disease and type 2 diabetes mellitus.

The aim of the study was the investigation of interrelations of soluble CD14 (sCD14) with degree of insulin resistance in patients with ischemic heart disease with and without type 2 diabetes mellitus in heart failure (HF) progression. Levels of sCD14 and insulin were measured by enzyme-linked immunosorbent assay, lipids – by enzymatic assay. Insulin resistance was evaluated with the homeostasis model (HOMA-IR). In diabetic patients
sCD14 level was elevated in HF II functional class, but the increase of HF severity wasn’t accompanied with its further elevation. In patients without diabetes sCD14 concentration was augmented in HF III-IV functional classes. Negative correlation of sCD14 level with insulin and HOMA-IR was revealed in non-diabetic patients. In patients with HF III–IV functional classes the correlation was most powerful. According to results of multiple linear regression in patients with diabetes sCD14 level negatively depended on low density lipoprotein cholesterol, high density lipoprotein cholesterol and triglycerides. There were no significant interrelations between sCD14 and lipids in patients without diabetes. Thus, in patients with ischemic heart disease and type 2 diabetes mellitus sCD14 level elevated already in early HF. In non-diabetic patients sCD14 level increased only in moderate-advanced HF and negatively correlated with insulin level and insulin resistance. In patients with diabetes in contrast to patients without diabetes low density lipoproteins, high density lipoproteins and triglycerides-rich lipoproteins apparently play significant role in the regulation of sCD14 secretion in HF contributing to attenuation of its production.

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