Perfil das citocinas em pacientes com síndrome metabólica e doença arterial coronariana grave

Abstract

Metabolic syndrome is a public health problem due to its high prevalence, once it is characterized by a set of risk factors that, when associated, predisposes to the development of atherosclerosis and its complications (acute myocardial infarction and stroke) and diabetes mellitus type 2. These risk factors are interconnected by biochemical, clinical, metabolic and inflammatory reactions. Chronic inflammation is closely related to the adipose tissue, predisposing to an induction of various cytokines which constitutes an important link between insulin resistance and endothelial dysfunction, precursor of atherosclerosis. The aim of this study was to evaluate the profile of cytokines in patients with metabolic syndrome and severe coronary artery disease. This was a controlled cross-sectional study with descriptive-analytic approach in patients treated at the Cardiometabolic Clinic of the Hospital São Lucas / PUCRS, Porto Alegre, Brazil. The sample was composed of three independent groups. Group 1 (n = 30) was composed of patients diagnosed with metabolic syndrome without significant coronary artery disease; group 2 (n = 30) was composed of patients with metabolic syndrome but with severe coronary artery disease; and group 3, control group, comprised healthy individuals. The activities of pro and anti-inflammatory cytokines, the oxidative stress, the anthropometric data and the biochemical data were evaluated. Levels of pro-inflammatory interleukins (TNF-α, IL-6, IL-12) were significantly higher in group 1, and so were IL-10 (anti-inflammatory) levels in this group. The main finding of this study showed that high IL-10 levels in patients with metabolic syndrome are associated with lower incidence of severe coronary artery disease, suggesting a protective effect through its anti-inflammatory activity, even in the presence of increased levels of other pro-inflammatory cytokines. Low IL-10 levels are associated with higher incidence of severe coronary artery disease in this population.