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[Correlation between insulin resistance and myocardial injury in critically ill children]
Feng Jiang1, Xiang-Ping Ma, Duolikun Muzhapaer
1Department of Pediatrics, Xinjiang Medical University, Urumqi, China.
Insights
Children with critical illnesses experiencing insulin resistance show increased myocardial injury. The Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) index can predict the severity of cardiac damage in these patients.
Area of Science:
- Pediatric Critical Care Medicine
- Endocrinology
- Cardiology
Context:
- Children with critical illnesses often exhibit both insulin resistance and myocardial injury.
- Understanding the interplay between these conditions is crucial for effective management.
Purpose:
- To investigate the relationship between insulin resistance and myocardial injury in critically ill children.
- To evaluate the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) as a predictive marker for myocardial injury.
Summary:
- Sixty-three critically ill children were assessed for insulin resistance using HOMA-IR and markers of myocardial injury (cardiac enzymes, troponin I).
- The insulin resistance group (HOMA-IR > 1.0) demonstrated significantly higher levels of myocardial injury markers compared to non-insulin resistant and control groups.
- A positive correlation was observed between HOMA-IR and various myocardial injury indicators in the insulin resistance group.
Impact:
- Insulin resistance exacerbates myocardial injury in critically ill children.
- HOMA-IR serves as a valuable prognostic indicator for the degree of myocardial injury in this vulnerable population.
Objective:
To study the relationship between insulin resistance and myocardial injury in children with critical diseases in light of the fact that such children usually suffer from noticeable insulin resistance and myocardial injury.
Methods:
Sixty-three children with critical diseases who were admitted between March 2010 and June 2011 were enrolled to comprise a case group. Fasting blood glucose, serum insulin, myocardial enzyme, and troponin I (CTnI) levels were measured. The insulin resistance index (HOMA-IR) was calculated. The children were classified into two groups: insulin resistance (HOMA-IR>1.0; n=30) and non-insulin resistance (HOMA-IR≤1.0; n=33). Thirty healthy children served as the control group.
Results:
HOMA-IR, lactate dehydrogenase (LDH), aspartate aminotransferaseaspartate transaminase (AST), creatine kinase (CK), isoenzymes of creating kinase (CK-MB), α-hydroxybuty rate dehydrogenase (α-HBDH) and CTnI in the insulin resistance group were higher than those in the non-insulin resistance and the control groups (all P<0.05). The non-insulin resistance group also showed obviously higher levels in terms of LDH, AST, CK, CK-MB, α-HBDH, and CTnI than the control group (P<0.05). In the insulin resistance group, there exists a positive correlation between HOMA-IR and such indicators as LDH, CK, CK-MB, AST, α-HBDH and CTnI (r=0.697, 0.739, 0.781, 0.642, 0.381, 0.792 respectively; all P<0.05).
Conclusions:
Insulin resistance makes myocardial injury more serious; HOMA-IR can serve as a forecast indicator for the degree of myocardial injury.
