The role of serum catestatin in lipid metabolism disorders in patients with coronary artery disease and chronic heart failure depending on concomitant metabolic pathology

Background. The problem of lipid metabolism disorders in patients with coronary artery disease and chronic heart failure, especially with concomitant type 2 diabetes mellitus and obesity, is highly relevant due to their high prevalence, significant contribution to cardiovascular morbidity and mortality, and the complexity of correction. Researching the role of catestatin in this complex clinical scenario opens new perspectives for understanding the pathogenesis of dyslipidemia and developing potential therapeutic strategies. Purpose – to evaluate the levels of lipid metabolism parameters, serum catestatin, and to establish correlations between the studied parameters in patients with coronary artery disease and chronic heart failure depending on concomitant metabolic pathologies such as type 2 diabetes mellitus and obesity. Materials and Methods. The study included 225 patients with chronic heart failure and coronary artery disease. Patients were divided into four groups: Group 1 – chronic heart failure with coronary artery disease, concomitant type 2 diabetes mellitus and obesity (n=75), Group 2 – chronic heart failure with coronary artery disease and concomitant type 2 diabetes mellitus (n=50), Group 3 – chronic heart failure with coronary artery disease and concomitant obesity (n=50), Group 4 – chronic heart failure of ischemic origin without metabolic disorders (n=50). The levels of catestatin, total cholesterol, high-density lipoprotein cholesterol, triglycerides, low-density lipoprotein cholesterol, very low-density lipoprotein cholesterol and the atherogenic coefficient were determined. Results. Patients in Group 1 showed a significant increase in total cholesterol, triglycerides, low-density lipoprotein cholesterol, very low-density lipoprotein cholesterol, the atherogenic coefficient and a decrease in high-density lipoprotein cholesterol compared to other groups (p < 0.05). Catestatin levels were the lowest in Group 1 and significantly different from other groups (p < 0.05). Significant correlations were found between catestatin levels and lipid metabolism parameters: negative correlations with triglycerides, low-density lipoprotein cholesterol, very low-density lipoprotein cholesterol, the atherogenic coefficient and a positive correlation with high-density lipoprotein cholesterol levels. Conclusions. Patients with chronic heart failure and coronary artery disease complicated by type 2 diabetes mellitus and obesity exhibit the most pronounced lipid profile disorders and a significant decrease in catestatin levels. The data obtained indicate an important role of catestatin in the regulation of lipid metabolism and emphasize the need for a comprehensive approach to the treatment of this category of patients.