Plasma mannose as a novel marker of myocardial infarction across different glycaemic states: a case control study

Abstract

Background Plasma mannose, an emerging novel biomarker of insulin resistance, is associated with both diabetes mellitus and coronary atherosclerosis, but the relationship between mannose concentrations and myocardial infarction (MI) across different glycaemic states remains to be elucidated. The aim of this study was to investigate the independent association between mannose and a first MI in a group of subjects characterized according to their glycaemic state. Methods Fasting plasma mannose concentrations were analysed in 777 patients 6–10 weeks after a first myocardial infarction and in 770 matched controls by means of high-performance liquid chromatography coupled to tandem mass spectrometry. Participants without known diabetes mellitus were categorized by an oral glucose tolerance test (OGTT) as having normal glucose tolerance (NGT, n = 1045), impaired glucose tolerance (IGT, n = 246) or newly detected type 2 diabetes (T2DM, n = 112). The association between mannose and MI was investigated across these glycaemic states by logistic regression. Results Mannose levels increased across the glycaemic states (p < 0.0001) and were significantly associated with a first MI in the whole study population (odds ratio, OR: 2.2; 95% CI 1.4 to − 3.5). Considering the different subgroups separately, the association persisted only in subjects with NGT (adjusted OR: 2.0; 95% CI 1.2–3.6), but not in subgroups with glucose perturbations (adjusted OR: 1.8, 95% CI 0.8–3.7). Conclusions Mannose concentrations increased across worsening levels of glucose perturbations but were independently associated with a first MI only in NGT individuals. Thus, mannose might be a novel, independent risk marker for MI, possibly targeted for the early management of previously unidentified patients at high cardiovascular risk.

Metabolomics Profiling of Stages of Coronary Artery Disease Progression

“…Additionally, galactose intake has been implicated in adverse cardiovascular effects [ 34 ]. Conversely, plasma mannose levels have been proposed as a new indicator for myocardial infarction and cardiovascular outcomes [ 35 ]. Our findings align with this evidence, showing a rise in mannose levels (estimate: 0.171) alongside an increased CAD risk.…”

“…Furthermore, our research reveals a significant positive association between mannose levels and systolic blood pressure in CAD patients, suggesting that elevated mannose levels may enhance the risk of atherosclerotic vascular disease. On the other hand, it was stated that the association between mannose and myocardial infarction will not remain in case of blood glucose abnormalities [ 35 ]. Considering the elevated HbA1c levels in our complications and CAD groups, the predictive power of the mannose metabolite should be validated in future studies.…”

Empagliflozin improves insulin sensitivity in patients with recent acute coronary syndrome and newly detected dysglycaemia

“…The fact that plasma mannose, an emerging, sensitive marker of insulin resistance and cardiovascular disease [ 24 , 25 ], was not affected by empagliflozin treatment could be due to the presence of significant differences already at baseline not only between the two treatment groups, but also according to the glycaemic groups, therefore further restricting the sample size.…”