Background:Inflammatory processes are implicated in the etiology of cardiovascular disease (CVD). Data on the association of inflammatory markers with cardiovascular risk factors in Indian patients with CVD are limited.Aim:This study was conducted with the aim to evaluate the association of inflammatory markers with traditional and nontraditional cardiovascular risk factors in angiographically proven coronary artery disease (CAD) patients.Subjects and Methods:We studied the association of serum highly sensitive C-reactive protein (hsCRP) (0.1-37.9 mg/l), interleukin-6 (IL-6) (2-253.2 pg/ml) and tumor necrosis factor-alpha (TNF-α) (8-525.8 pg/ml) with cardiovascular risk factors in 300 (M: 216, F: 84; mean age: 60.9 (12.4) years) CAD patients. All patients were evaluated for anthropometry and cardiovascular risk factors, and blood samples were collected for biochemical and inflammatory markers. Statistical analysis was carried out using SPSS Version 20.Results:Mean hsCRP, IL-6 and TNF-α in study population were 11.7 (9.7) mg/l, 64.5 (75.2) pg/ml, and 25.3 (40.9) pg/ml respectively. A total of 73.6% (221/300) patients had hsCRP levels >3.0 mg/l. All inflammatory markers were significantly higher and showed a positive correlation with dyslipidemia, diabetes mellitus, and/or hypertension (HTN). TNF-α had a negative correlation with age and positive correlation with smoking. Only IL-6 and hsCRP had a positive correlation with insulin resistance and negative correlation with insulin secretion. Among lipid parameters, triglyceride had a positive correlation, and high density lipoprotein had a negative correlation with all inflammatory markers. There was a progressive increase in the percentage of subjects with diabetes, HTN, and dyslipidemia with increasing levels of inflammatory markers.Conclusions:Indian patients with CAD had significantly high levels of inflammatory markers, which were related to cardiovascular risk factors.
INTRODUCTIONMagnesium is the second most abundant intracellular cation and is an essential element that has numerous biological functions. Magnesium is plentiful in green leafy, cereal, grain, nuts and legumes, however, refining or processing of food may deplete magnesium content by nearly 85% 1 . About 30% of ingested magnesium is absorbed by distal small intestine. Magnesium acts as a cofactor in many of enzymatic reactions in the human body. Magnesium is essential for the synthesis of nucleic acids and proteins, for intermediary metabolism particularly related to the neuromuscular and cardiovascular systems. Over 300 enzymes are dependent on magnesium. Magnesium influences the enzymatic activity by binding to legends such as ATP in ATP-requiring enzymes, enolase, pyruvate kinase, and pyrophosphatase, leading to conformational change during ABSTRACT Background: Magnesium plays an important role in regulating insulin action and secretion. Dietary magnesium deficiency and hypomagnesemia have been associated with inflammation. There is paucity of data regarding this in Indian subjects. Hence, we studied the relation of serum and dietary magnesium with insulin resistance (IR) and inflammatory markers. Methods & Results:We studied the relation of serum high sensitive C-Reactive Protein (hsCRP), interlukin-6 (IL-6) and tumor Necrosis Factor (TNF-α) with cardiovascular risk factors in three hundred coronary artery disease patients. Nutrition assessment was done at the time of recruitment. Patients were evaluated for anthropometry, cardiovascular risk factors, and blood samples were collected. Patients were divided into three groups according to serum magnesium levels; ≤1.6 (Group 1), >1.6-2.6 (Group 2) and: >2.6 mg/dl (Group 3) and into two groups according to recommended dietary allowance (RDA) for magnesium (≤350 mg/day and >350 mg/day). More than half of patients (58.6%) were having hypomagnesemia and 62% were consuming magnesium below RDA. Insulin and IR was significantly higher and insulin sensitivity was significantly lower in group 1 compared to group 2 and 3. Insulin and IR was correlated negatively; and insulin sensitivity was correlated positively with serum magnesium. Similarly inflammatory markers were significantly higher in group1 when compared with group 2 and 3 and they were correlated negatively with serum magnesium. Dietary magnesium was positively correlated with serum magnesium. Insulin and IR were significantly higher and insulin sensitivity was significantly lower in subjects with low RDA for magnesium. Insulin and IR were correlated negatively and sensitivity was correlated positively with dietary magnesium. Inflammatory markers; IL-6, TNF-α, and hs CRP were significantly high in subjects with low RDA for magnesium and were correlated negatively with dietary magnesium. Conclusion: Hypomagnesemia and low dietary magnesium is associated with IR and inflammatory markers in patients with coronary artery disease.
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