c-peptide and Heart-Valve-Diseases

Hyperinsulinaemia and dyslipoproteinaemia are markers and risk factors for coronary artery disease (CAD) and non-insulin-dependent diabetes mellitus (NIDDM). We investigated the influence of a tumour necrosis factor beta (TNF-beta) gene polymorphism on serum parameters related to these metabolic disorders in patients with CAD.. A total of 199 patients with CAD and 81 control subjects with angiographically normal coronary arteries were studied. A digestion of amplified DNA with NcoI revealed three fragment patterns: homozygosity for TNF-beta *1 or TNF-beta *2 and heterozygosity (TNF-beta *1/*2).. Patients with CAD who had increased serum insulin or C-peptide (fasting and after glucose load) were predominantly heterozygous for TNF-beta (72% vs. 47%) and less frequently homozygous for TNF-beta *2 (22% vs. 43%, P = 0 x 0.03).. This study demonstrates an association of TNF-beta alleles with the risk factor hyperinsulinaemia in CAD. Genomic variants of TNF-beta may therefore contribute to the complex susceptibility for the metabolic syndrome in patients with CAD.

Topics: Alleles; C-Peptide; Coronary Disease; Gene Frequency; Glucose Tolerance Test; Heart Valve Diseases; Heterozygote; Homozygote; Humans; Hyperinsulinism; Insulin; Lymphotoxin-alpha; Male; Middle Aged; Polymorphism, Genetic

To evaluate the changes of endocrine and exocrine pancreatic function in patients who underwent heart valve replacement under cardiopulmonary bypass (CPB) in order to optimally conside clinical management perioperatively.. Sixteen patients with heart valve disease were selected. Serum glucose, lactate, insulin, C peptide, amylase and lipase were measured.. Hyperglycemia and hyperlactacemia were noted after CPB and peaked at 19:00 on the operative day. Their changes were correctly correlated. Serum glucose and lactate returned to the baseline level on the third postoperative day. The average level of serum insulin were normal, but higher on the third postoperative day. However, the level of serum C peptide was higher than the baseline. It doubled the baseline level at 19:00 on the operative day. The average level of serum amylase and lipase was normal, except the higher level of serum lipase on the fourth postoperative day. In our group, 12 patients had normal serum amylase level perioperatively, and 4 increased serum amylase level (25%), among them 2 patients accompanied with hyperlipasimia (16%). There were 8 patients with hyperlipasimia (50%).. The endocrine and exocrine pancreatic functions were influenced by CPB and did produce pathophysiologic changes.

Topics: Adult; Amylases; Blood Glucose; C-Peptide; Cardiopulmonary Bypass; Female; Heart Valve Diseases; Humans; Insulin; Lactates; Lipase; Male; Pancreas