Endothelial and Metabolic Biomarkers in Diabetic Coronary Artery Disease

Background. Coronary artery disease frequently develops as a consequence of type 2 diabetes mellitus, which leads to an exacerbation of both diseases. Persistently elevated glucose levels promote glycation of proteins and lipids, induce chronic inflammation, and increase the risk of cardiovascular events. The study aimed to evaluate metabolic, glycation-related, inflammatory, and endothelial-related variables in patients with type 2 diabetes with and without acute coronary syndrome (ACS). Methods. The study included patients aged 73.5 ± 6.4 years with ACS (n = 42) and other cardiac conditions (n = 33). The diagnosis of ACS was established in accordance with European Society of Cardiology guidelines. Results. The triglyceride–glucose (TyG) index was significantly higher in ACS, whereas the triglyceride–glucose body mass index (TyG-BMI) did not differ significantly between groups. The triglyceride-to-high-density lipoprotein cholesterol (TG/HDL) ratio, as a marker for insulin resistance and atherosclerosis, exceeded 2. Advanced glycation end products (AGEs) and soluble receptors for advanced glycation end products (sRAGEs) were significantly elevated in ACS, whereas the AGE/sRAGE ratio did not differ significantly between groups. Reduced nitric oxide (NO) bioavailability was accompanied by a decrease in soluble endoglin (sEng). Receiver operating characteristic (ROC) analysis showed only modest discriminatory performance for the evaluated endothelium-related variables. Conclusions. Patients with ACS present a wide spectrum of metabolic and vascular abnormalities, including atherogenic dyslipidemia, altered insulin resistance indices, and reduced NO and sEng levels.