Relationship between Interleukin 20 and Insulin Resistance in Men with Type 2 Diabetes Melletus and Myocardial Infraction Patients in Al-anbar Governorate

Abstract

Myocardial infarction (MI) is the state of death of myocardial cells as a result of ischemia . This state is associated with several factors that increase the risk of developing (MI), from these factors, hyperglycemia, caused by an insulin hyposecretory , insulin resistance or both, as well as obesity and hyperlipidemia. The main objective of this study was to accurately measure of insulin resistance and interleukin-20 (IL-20) to explore the possible relationship between them in patients with (MI) and type 2 diabetes (T2DM), and explore the relationship between these parameters with some anthropometric measurements (AMs) and some biomarkers. This study included 30 healthy control samples and 50 patient samples, all males aged between 35 to 70 years, were collected from Ramadi Teaching Hospital in Ramadi and Fallujah Teaching Hospital in Fallujah during the period from September 2020 to January 2021 . Serum levels of interleukin-20 and insulin were estimated by Enzyme Linked Immune-Sorbent Assay (ELISA), other variables were also estimated using advanced laboratory equipment and methods . In this study the following results were obtained, there was a significant increase in the level of fasting insulin (P <0.05) in patients (10.28) (µUI/ml) compared to the healthy subjects (6.077) (µUI/ml), and there was a significant increase (P <0.05) when calculating the HOMA2- IR value in patients (3.608) compared to healthy controls (1.309), while there was a significant decrease (p <0.05) when calculating the HOMA2- β% value in patients (52.57) compared to healthy controls (91.38). ). On the other hand, a significant increase in the mean serum levels of IL-20 was observed in patients (570.9) (pcg / ml) compared to the healthy population (346.5 pcg / ml). Also, according to age, there was no II significant difference (p> 0.05) between the healthy group and the patient group, as the mean of age was (50.27) and (52.54) years of healthy subjects and for patients respectively, the mean of BMI showed a non significant (P> 0.05) in patients (29.11) kg / m2 compared to healthy subjects (28.53) kg / m2 . A significant increase was observed (p <0.05)) in serum levels of troponin between patients (15.63) (ng /ml) and healthy subjects (0.0216) (ng /ml). Also, there was a significant increase (p <0.05) for the serum creatine phosphokinase levels of patients (68.09) (ng/ml) compared to healthy subjects (1.394) (ng / ml) . Pearson correlation analysis showed that there was a strong positive association between interleukin-20 and HOMA-IR (r=0.686, P=<0.001), negative with HOMA-β% (r = -0.514, P = <0.001) and positive with glucose level (r = 0.620, P = <0.001) and fasting insulin (r = 0.589, P = <0.001). There was no association of interleukin-20 with age, BMI (r = 0.151, 0.028, P = 0.183,0.804, respectively).The correlation of interleukin-20 with both troponin and creatine phosphokinase was strong positive (r = 0.626, P = <0.001), (r = 0.632, P = <0.001), respectively. According to (ROC curve) analysis, both BMI age, are false positive rates and do not describe patients' pathology (P> 0.05), on the other hand, FSG, HOMA2IR, HOMA2-β, CK-MB ,Troponin-T, FSI and IL -20 are true positive rates and describe the Pathological case of the patients (P<0.05).