| Objective:By comparing the plasma levels of NLRP3 and its downstream factors,interleukin-1 beta(IL-1 beta)and interleukin-18(IL-18)in different cases,the correlation between plasma NLRP3 and its downstream factors,IL-1 beta and IL-18,and acute coronary syndrome with type 2 diabetes mellitus was explored,and the relationship between type 2 diabetes mellitus and acute coronary syndrome was further compared.Gensini score of three subgroups in group A was used to investigate the correlation between plasma NLRP3 and its downstream factors IL-1beta and IL-18 and the severity of coronary artery disease.Methods : 1.Case collection and grouping: 160 patients from October 2016 to December 2018 in the Department of Cardiology of Dongguan Cerebrovascular Disease Area,Affiliated Hospital of Yan’an University were enrolled in the normal control group(n=40),simple type 2 diabetes group(n=40),simple acute coronary syndrome group(n=40),acute coronary syndrome with type 2 diabetes group(n=40),including acute coronary syndrome with type 2 diabetes mellitus group(n=40).Pulse syndrome patients with type 2 diabetes mellitus were divided into three subgroups: unstable angina pectoris group(n=14),non-ST-segment elevation myocardial infarction group(n=14)and ST-segment elevation myocardial infarction group(n=12).General clinical and biochemical data of each group were collected.2.Separation and extraction of peripheral blood plasma: 5 ml of whole blood from median elbow vein of each group was extracted and placed in EDTA anticoagulant tube.The plasma of each group was separated and extracted by ordinary high-speed centrifugation method.The upper plasma was collected in 1.5 ml EP tube and stored in-80 cryogenic refrigerator for reserve.3.Determine the contents of NLRP3,IL-1beta and IL-18 in plasma: The contents ofNLRP3,IL-1beta and IL-18 in plasma of each group were determined by ELISA.4.Gensini scores were assessed in three subgroups of type 2 diabetes mellitus with acute coronary syndrome.5.General data of sex,age,smoking history,hypertension history and clinical biochemical indicators such as fasting blood glucose,triglyceride and total cholesterol were collected.6.To compare and analyze the differences of the above-mentioned general data,clinical biochemical indicators,laboratory indicators and Gensini scores,and make statistical analysis.To analyze the role of plasma NLRP3 and its downstream factors IL-1beta and IL-18 in type 2 diabetes mellitus complicated with acute coronary syndrome and their correlation with the severity of coronary artery disease.Results:1.General and clinical biochemical data results: There were no significant differences in gender,age,smoking history,hypertension history and other general data in each group(P>0.05).There were no significant differences in serum triglycerides and total cholesterol among the groups(P>0.05).Normal control group,simple acute coronary syndrome group,simple type 2 diabetes mellitus,acute coronary syndrome with type 2 sugar were also found.There was significant difference in fasting blood sugar between the two groups(P<0.05).2.There was no significant difference in gender,age,smoking history and hypertension history among the three subgroups(P>0.05),and there was no significant difference in fasting blood glucose,serum triglyceride and total cholesterol among the three subgroups(P>0.05).3.ELISA results:1).The plasma levels of NLRP3 in simple type 2 diabetes mellitus group,simple acute coronary syndrome group and acute coronary syndrome combined with type 2diabetes mellitus group were(106.62 ±16.71)ng/L,(130.00±26.24)ng/L,(223.59±37.19)ng/L,respectively,which were significantly higher than those in normal control group(79.27±17.43)ng/L,with significant difference(P<0.05).Among them,acute coronary syndrome combined with type 2 diabetes mellitus group had significant difference(P<0.05).The plasma NLRP3 level in diabetic patients was significantly higher than that in simple acute coronary syndrome group and simple type 2 diabetes group(P<0.05).2).Among the three subgroups of acute coronary syndrome with type 2 diabetes mellitus,the plasma NLRP3 levels in non-ST-segment elevation myocardial infarction group and ST-segment elevation myocardial infarction group were(228.49±27.06)ng/L and(250.80 ±39.09)ng/L,respectively,which were significantly higher than those in unstable angina group(195.36±23.61)ng/L,(P<0.05),but in non-ST-segment elevation myocardial infarction group and ST-segment elevation myocardial infarction group.There was no significant difference in plasma NLRP3 level in the dead group(P>0.05).3).The levels of IL-1β in plasma of type 2 diabetes group,acute coronary syndrome group and acute coronary syndrome group with type 2 diabetes group were(22.57±3.11)ng/L,(22.25±3.25)ng/L,(25.96±3.78)ng/L,respectively,which were significantly higher than those of normal control group(13.50±3.41)ng/L,the difference was significant(P<0.05),acute coronary syndrome group with type 2 diabetes mellitus group.The plasma level of IL-1β in patients with acute coronary syndrome and type 2 diabetes mellitus was significantly higher than that in patients with simple acute coronary syndrome(P<0.05).4).Among the three subgroups of acute coronary syndrome complicated with type 2diabetes,the plasma IL-1βlevels in non-ST-segment elevation myocardial infarction group and ST-segment elevation myocardial infarction group were(26.34±2.77)ng/L and(28.59±3.01)ng/L,respectively,which were significantly higher than those in unstable angina group(23.32±3.67)ng/L,(P<0.05),but in non-ST-segment elevation myocardial infarction group and ST-segment elevation myocardial infarction group There was no significant difference in the content of IL-1β in plasma(P>0.05).5).The plasma levels of IL-18 in type 2 diabetes mellitus group,acute coronary syndrome group and acute coronary syndrome group with type 2 diabetes mellitus were(102.62±13.14)ng/L,(113.21±14.96)ng/L and(129.27±23.22)ng/L,respectively,which were significantly higher than those in normal control group(50.20±11.77)ng/L,with significant difference(P<0.05),acute coronary syndrome with type 2 diabetes mellitus.The level of IL-18 in plasma of patients with acute coronary syndrome was significantlyhigher than that of patients with type 2 diabetes mellitus(P<0.05).6).Among the three subgroups of acute coronary syndrome with type 2 diabetes mellitus,the plasma IL-18 levels in non-ST-segment elevation myocardial infarction group and ST-segment elevation myocardial infarction group were(132.94±18.80)ng/L)and(144.99±17.84)ng/L,respectively,which were significantly higher than those in unstable angina group(112.14±20.88)ng/L(P<0.05),in non-ST-segment elevation myocardial infarction group and ST-segment elevation myocardial infarction group There was no significant difference in the content of IL-18 in plasma(P>0.05).4.Gensini score comparison resultsGensini scores of non-ST-segment elevation myocardial infarction group and ST-segment elevation myocardial infarction group were(72.00±17.40)and(73.00±18.04)respectively,which were significantly higher than those of unstable angina group(35.86±13.50)(P < 0.05).Gensin scores of non-ST-segment elevation myocardial infarction group and ST-segment elevation myocardial infarction group were further compared.There was no significant difference in I score(P > 0.05).5.Relevance analysis:1).There was a positive correlation between plasma IL-1βand plasma NLRP3 in each group,the correlation coefficient r=0.671(P <0.05).2).There was a positive correlation between plasma IL-18 and plasma NLRP3 in each group,the correlation coefficient r=0.693(P<0.05).3).There was a positive correlation between plasma NLRP3 and Gensini score in subgroup,and the correlation coefficient r = 0.618(P < 0.05).4).There was a positive correlation between plasma IL-1beta and Gensini score in subgroup,and the correlation coefficient r = 0.510(P < 0.05).5).There was a positive correlation between plasma IL-18 and Gensini score in subgroup,and the correlation coefficient r=0.620(P<0.05).Conclusion: The Plasma NLRP3 and its downstream factors IL-1β,IL-18 are associated with1.the development and progression of type 2 diabetes with acute coronarysyndrome.We hypothesize that NLRP3 inflammatory bodies may be mediated by its downstream inflammatory factor IL-1β.IL-18 exerts its pro-inflammatory effect.2.The higher the plasma levels of NLRP3 and its downstream factors IL-1beta and IL-18,the worse the coronary lesions and the more serious the condition of type 2diabetes mellitus patients with acute coronary syndrome. |
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