Differential Ophthalmological Profile in Patients with Coronary Artery Disease Coexisting with Type 2 Diabetes Mellitus: Elevated Tear Cytokine Concentrations
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Participants
2.2. Eligibility Criteria
2.3. Coronary Assessment and Clinical Characteristics
2.3.1. Coronary Angiography and Computed Tomography
2.3.2. Baseline Clinical Characteristics
2.4. Ophthalmological Assessment and Collection of Tear Samples
2.4.1. Ophthalmological Parameter Determination
2.4.2. Collection of Tear Samples
2.5. Processing of Tear Samples and Determination of Inflammatory Mediators
2.6. Statistical Analysis
3. Results
3.1. Clinical Characteristics of Patients with CAD
3.2. Ophthalmological Parameters and Tear Cytokine Concentrations in Patients with CAD Based on T2DM
3.2.1. Ophthalmological Parameters
3.2.2. Tear Cytokine Concentrations
3.3. Correlation between Significant Ophthalmological Parameters and Tear Cytokine Concentrations in Patients with CAD
3.4. Influence of Other Age, Sex, and Classical Cardiovascular Risk Factors on Significant Ophthalmological Parameters and Tear Cytokine Concentrations in Patients with CAD Based on T2DM
3.4.1. Effects of Comorbid T2DM and Other Cardiovascular Risk Factors on Significant Ophthalmological Parameters
3.4.2. Effects of Comorbid T2DM and Other Cardiovascular Risk Factors on Significant Cytokine Concentrations
3.5. Logistic Regression Models to Differentiate Patients with CAD Based on the Coexistence or Not of T2DM
3.5.1. Full Logistic Regression Model
3.5.2. Reduced Logistic Regression Model
4. Discussion
Limitations and Future Perspectives
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variable | CAD | p-Value | |||
---|---|---|---|---|---|
Total | Non-T2DM | T2DM | |||
Participants (n) | 72 | 40 | 32 | --- | |
Sex, women [n (%)] | 18 (25.0) | 12 (30.0) | 6 (18.8) | 0.412 a | |
Age (years) (mean ± SD) | 60.7 ± 8.7 | 59.5 ± 7.9 | 62.4 ± 9.2 | 0.158 b | |
Smoking habit [n (%)] | 32 (44.4) | 22 (55.0) | 10 (31.3) | 0.092 a | |
Medical history and prior cardiovascular diseases [n (%)] | Hypercholesterolemia | 25 (34.7) | 10 (25.0) | 15 (46.9) | 0.081 a |
Obesity | 30 (41.7) | 15 (37.5) | 15 (46.9) | 0.476 a | |
COPD | 7 (9.7) | 4 (10.0) | 3 (9.4) | >0.999 a | |
Chronic kidney disease | 5 (6.9) | 2 (5.0) | 3 (9.4) | 0.650 a | |
High blood pressure | 36 (50.0) | 16 (40.0) | 20 (62.5) | 0.096 a | |
CAD | 12 (16.7) | 6 (15.0) | 6 (18.8) | 0.756 a | |
Peripheral artery disease | 2 (2.8) | 0 (0.0) | 2 (6.3) | 0.194 a | |
Stroke/TIA | 3 (4.2) | 1 (2.5) | 2 (6.3) | 0.582 a | |
Atrial fibrilation/arrhythmia | 8 (11.1) | 4 (10.0) | 4 (12.5) | >0.999 a | |
CAD type [n (%)] | Chronic CAD | 24 (33.3) | 13 (32.5) | 11 (34.4) | 0.983 a |
STEMI | 18 (25.0) | 10 (25.0) | 8 (25.0) | ||
NSTEMI | 30 (41.7) | 17 (42.5) | 13 (40.6) | ||
CAD severity [n (%)] | Non-significant lesions | 18 (25.0) | 11 (27.5) | 7 (21.9) | 0.267 a |
Single-vessel disease | 21 (29.2) | 14 (35.0) | 7 (21.9) | ||
Multi-vessel disease | 33 (45.8) | 15 (37.5) | 18 (56.3) | ||
Blood parameters at admission (mean ± SD)/[median (IQR)] | Albumin (g/dL) | 3.3 ± 0.6 | 3.3 ± 0.8 | 3.2 ± 0.4 | 0.493 b |
Creatinine (mg/dL) | 0.98 (0.78–1.18) | 1.01 (0.75–1.22) | 0.96 (0.80–1.15) | 0.891 c | |
Hemoglobin (g/dL) | 13.9 ± 1.7 | 14.0 ± 2.1 | 13.6 ± 1.8 | 0.396 b | |
C-reactive protein (mg/L) | 16.6 ± 8.5 | 14.7 ± 8.0 | 18.0 ± 9.3 | 0.110 b | |
eGFR (mL/min/1.73 m2) | 78.25 (59.50–90.00) | 79.00 (65.25–90.00) | 77.50 (59.00–95.00) | 0.724 c | |
Treatment [n (%)] | Conservative | 23 (31.9) | 13 (32.5) | 10 (31.3) | >0.999 a |
PCI/CABG | 49 (68.1) | 27 (67.5) | 22 (68.8) |
Ophthalmological Parameter | CAD | p-Value a,b | Adjusted p-Value (q-Value) c | |
---|---|---|---|---|
Non-T2DM | T2DM | |||
Number of eyes examined (n) | 80 | 64 | --- | --- |
Intraocular pressure (mm Hg) (mean ± SD) | 15.05 ± 2.95 | 14.08 ± 2.96 | 0.053 a | ns |
BCVA [median (IQR)] | 1.00 (1.00–1.00) | 1.00 (0.90–1.00) | 0.029 b | ns |
Schirmer’s test (mm/5 min) [median (IQR)] | 18.00 (12.00–28.75) | 13.00 (9.00–26.00) | 0.043 b | ns |
TCCT (µm) (mean ± SD) | 550.55 ± 37.80 | 549.94 ± 38.36 | 0.925 a | ns |
PCCT (µm) (mean ± SD) | 549.06 ± 42.21 | 554.02 ± 36.77 | 0.475 a | ns |
Axial length (mm) (mean ± SD) | 23.66 ± 0.91 | 23.57 ± 1.57 | 0.722 a | ns |
CMT (µm) (mean ± SD) | 269.08 ± 28.35 | 267.18 ± 28.56 | 0.696 a | ns |
MCV (mm3) (mean ± SD) | 10.32 ± 0.51 | 10.02 ± 0.48 | 0.001 a | 0.008 |
MMT (µm) (mean ± SD) | 286.51 ± 14.11 | 277.93 ± 13.42 | >0.001 a | 0.004 |
RNFLT (µm) (mean ± SD) | 92.65 ± 10.90 | 86.51 ± 12.21 | 0.002 a | 0.012 |
GCLT (µm) (mean ± SD) | 81.59 ± 10.46 | 76.20 ± 11.74 | 0.005 a | 0.015 |
GCLMT (µm) (mean ± SD) | 76.11 ± 17.94 | 69.62 ± 16.34 | 0.037 a | ns |
Choroidal thickness (µm) (mean ± SD) | 306.95 ± 64.73 | 292.00 ± 82.28 | 0.247 a | ns |
Inflammatory Mediator | CAD | p-Value a | Adjusted p-Value (q-Value) b | |
---|---|---|---|---|
Non-T2DM | T2DM | |||
Number of eyes examined (n) | 80 | 64 | --- | --- |
IL-1β (pg/mg) [median (IQR)] | 0.305 (0.200–0.400) | 0.269 (0.195–0.464) | 0.842 | ns |
IL-1ra (ng/mg) [median (IQR)] | 4.021 (3.102–6.076) | 4.991 (4.268–6.565) | 0.003 | 0.024 |
IL-4 (pg/mg) [median (IQR)] | 0.273 (0.215–0.349) | 0.364 (0.291–0.441) | <0.001 | 0.017 |
IL-5 (pg/mg) [median (IQR)] | 0.900 (0.200–1.845) | 3.508 (2.727–4.500) | <0.001 | 0.005 |
IL-6 (pg/mg) [median (IQR)] | 0.818 (0.542–1.785) | 1.614 (0.665–2.549) | 0.005 | 0.026 |
IL-7 (pg/mg) [median (IQR)] | 4.795 (3.359–5.893) | 5.194 (3.456–6.888) | 0.142 | ns |
IL-8 (pg/mg) [median (IQR)] | 32.14 (22.60–62.33) | 69.62 (41.41–120.17) | <0.001 | 0.012 |
IL-9 (pg/mg) [median (IQR)] | 0.609 (0.020–4.208) | 3.546 (0.510–6.397) | 0.001 | 0.019 |
IL-13 (pg/mg) [median (IQR)] | 0.292 (0.185–0.508) | 0.404 (0.278–0.615) | 0.008 | 0.029 |
IL-17A (pg/mg) [median (IQR)] | 0.300 (0.300–0.600) | 0.400 (0.300–0.600) | 0.058 | ns |
TNF-α (pg/mg) [median (IQR)] | 2.200 (1.000–7.380) | 1.500 (1.000–2.500) | 0.069 | ns |
G-CSF (pg/mg) [median (IQR)] | 2.010 (0.073–9.893) | 14.749 (7.165–22.429) | <0.001 | 0.007 |
GM-CSF (pg/mg) [median (IQR)] | 0.459 (0.150–0.886) | 0.567 (0.420–0.794) | 0.011 | 0.031 |
IFN-γ (pg/mg) [median (IQR)] | 52.33 (38.60–67.17) | 62.93 (56.51–72.10) | 0.001 | 0.021 |
PDGF-BB (pg/mg) [median (IQR)] | 4.510 (1.510–15.150) | 5.010 (1.635–7.510) | 0.127 | ns |
CCL2/MCP-1 (pg/mg) [median (IQR)] | 7.381 (3.188–19.015) | 6.306 (2.979–21.156) | 0.603 | ns |
CCL3/MIP-1α (pg/mg) [median (IQR)] | 0.174 (0.128–0.338) | 0.382 (0.212–0.490) | <0.001 | 0.014 |
CCL4/MIP-1β (pg/mg) [median (IQR)] | 1.488 (0.731–2.489) | 4.093 (2.404–5.660) | <0.001 | 0.010 |
CCL5/RANTES (pg/mg) [median (IQR)] | 24.72 (11.12–46.38) | 28.70 (20.25–49.21) | 0.034 | ns |
CCL11/eotaxin-1 (pg/mg) [median (IQR)] | 0.475 (0.354–0.629) | 0.685 (0.635–0.861) | <0.001 | 0.002 |
CXCL10/IP-10 (ng/mg) [median (IQR)] | 2.249 (1.445–3.100) | 2.314 (1.771–3.501) | 0.587 | ns |
Explanatory Variable and Constant | B | Standard Error | Wald (dg) | p-Value | Exp(B) (OR) | 95% CI for OR | |
---|---|---|---|---|---|---|---|
Lower | Upper | ||||||
Full Logistic Regression Model | |||||||
MCV (mm3 × 100) | 0.340 | 0.139 | 5.986 (1) | 0.014 | 1.405 | 1.070 | 1.846 |
MMT (µm) | −1.255 | 0.506 | 6.158 (1) | 0.013 | 0.285 | 0.106 | 0.768 |
IL-4 (pg/mL × 10) | −0.856 | 0.382 | 5.026 (1) | 0.025 | 0.425 | 0.201 | 0.898 |
IL-5 (pg/mL) | 0.737 | 0.193 | 14.518 (1) | <0.001 | 2.090 | 1.430 | 3.053 |
IL-6 (pg/mL) | −0.148 | 0.143 | 1.064 (1) | 0.302 | 0.863 | 0.652 | 1.142 |
IL-8 (pg/mL) | 0.008 | 0.007 | 1.357 (1) | 0.244 | 1.008 | 0.995 | 1.021 |
IL-9 (pg/mL) | −0.304 | 0.200 | 2.312 (1) | 0.128 | 0.738 | 0.499 | 1.092 |
IL-13 (pg/mL × 10) | 0.386 | 0.151 | 6.536 (1) | 0.011 | 1.471 | 1.094 | 1.977 |
G-CSF (pg/mL) | 0.362 | 0.102 | 12.636 (1) | <0.001 | 1.436 | 1.176 | 1.753 |
GM-CSF (pg/mL) | −0.011 | 0.194 | 0.003 (1) | 0.955 | 0.989 | 0.676 | 1.447 |
CCL3/MIP-1α (pg/mL × 10) | −0.887 | 0.370 | 5.736 (1) | 0.017 | 0.412 | 0.199 | 0.851 |
CCL4/MIP-1β (pg/mL) | 0.073 | 0.228 | 0.101 (1) | 0.751 | 1.075 | 0.687 | 1.683 |
CCL11/eotaxin-1 (pg/mL × 10) | 0.986 | 0.260 | 14.335 (1) | <0.001 | 2.680 | 1.609 | 4.465 |
Constant | 0.232 | 6.820 | 0.001 (1) | 0.973 | 1.261 | --- | --- |
Reduced logistic regression model (Backward method: Wald) | |||||||
IL-5 (pg/mL) | 0.519 | 0.146 | 12.617 (1) | <0.001 | 1.680 | 1.262 | 2.237 |
G-CSF (pg/mL) | 0.062 | 0.022 | 8.164 (1) | 0.004 | 1.064 | 1.020 | 1.109 |
CCL11/eotaxin-1 (pg/mL × 10) | 0.444 | 0.139 | 10.279 (1) | 0.001 | 1.560 | 1.189 | 2.046 |
Constant | −4.934 | 0.939 | 27.610 (1) | <0.001 | 0.007 | --- | --- |
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Jiménez-López, R.; Romero-Trevejo, J.L.; Fernández-Romero, L.; Martín-Chaves, L.; Romero-Cuevas, M.; Molina-Ramos, A.I.; Sánchez-Quintero, M.J.; Murri, M.; Costa, F.; Bodí, V.; et al. Differential Ophthalmological Profile in Patients with Coronary Artery Disease Coexisting with Type 2 Diabetes Mellitus: Elevated Tear Cytokine Concentrations. J. Clin. Med. 2024, 13, 4906. https://doi.org/10.3390/jcm13164906
Jiménez-López R, Romero-Trevejo JL, Fernández-Romero L, Martín-Chaves L, Romero-Cuevas M, Molina-Ramos AI, Sánchez-Quintero MJ, Murri M, Costa F, Bodí V, et al. Differential Ophthalmological Profile in Patients with Coronary Artery Disease Coexisting with Type 2 Diabetes Mellitus: Elevated Tear Cytokine Concentrations. Journal of Clinical Medicine. 2024; 13(16):4906. https://doi.org/10.3390/jcm13164906
Chicago/Turabian StyleJiménez-López, Rafael, José Lorenzo Romero-Trevejo, Lourdes Fernández-Romero, Laura Martín-Chaves, Miguel Romero-Cuevas, Ana Isabel Molina-Ramos, María José Sánchez-Quintero, Mora Murri, Francesco Costa, Vicente Bodí, and et al. 2024. "Differential Ophthalmological Profile in Patients with Coronary Artery Disease Coexisting with Type 2 Diabetes Mellitus: Elevated Tear Cytokine Concentrations" Journal of Clinical Medicine 13, no. 16: 4906. https://doi.org/10.3390/jcm13164906