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. 2025 Feb 17;22(1):8.
doi: 10.1186/s12014-025-09530-y.

Admission glucose, HbA1c levels and inflammatory cytokines in patients with acute ST-elevation myocardial infarction

Meisinger Christa  1 , Freuer Dennis  2 , Raake Philip  3 , Linseisen Jakob  2 , Schmitz Timo  2
Affiliations

Admission glucose, HbA1c levels and inflammatory cytokines in patients with acute ST-elevation myocardial infarction

Meisinger Christa et al. Clin Proteomics. .

Abstract

Background: To investigate the association between admission glucose and HbA1c values and inflammatory plasma proteins in hospitalized patients with acute ST-elevation myocardial infarction (STEMI).

Methods: This analysis was based on 345 STEMI patients recorded by the population-based Myocardial Infarction Registry Augsburg between 2009 and 2013. Using the OLINK inflammatory panel, a total of 92 protein biomarkers were measured in arterial blood samples, which were obtained within the scope of cardiac catheterization immediately after admission. The associations between admission glucose and HbA1c levels and the 92 protein markers were investigated using multivariable linear regression models.

Results: Admission glucose showed significantly positive associations with the inflammatory markers IL-10, IL-8, IL-6, FGF-21, IL-7, ST1A1, MCP-1, 4E-BP1, SIRT2, STAMBP and IL-18R1 after Bonferroni adjustment. HbA1c values were only significantly associated with IL-18R1. In stratified analyses, admission glucose was not significantly associated with any plasma protein in the diabetes subgroup, while there were several protein markers that showed significantly positive associations with admission glucose in STEMI patients without known diabetes, namely IL-10, CCL20, IL-8, MCP-1 and IL-6.

Conclusions: Admission glucose in patients hospitalized due to an acute STEMI seems to be related to an inflammatory and immune-related response, expressed by an increase in inflammation-related plasma proteins in particular in non-diabetic patients with stress hyperglycemia. The present results may open new avenues for the development of biomarkers suitable as potential diagnostic or prognostic clinical markers.

Keywords: Admission blood glucose; Cytokines; Glucose metabolism; HbA1c; Inflammatory plasma proteins; Myocardial infarction.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Data collection of the Augsburg MI registry has been approved by the ethics committee of the Bavarian Medical Association (Bayerische Landesärztekammer) and the study was performed in accordance with the Declaration of Helsinki. All study participants have given written informed consent. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Results of the linear regression models analyzing the association between admission glucose and inflammatory plasma proteins. The models were adjusted for sex, age, renal function, diabetes and BMI. P-values were Bonferroni-adjusted. Names of the markers are presented for all markers with Bonferroni-adjusted p-values below 0.05
Fig. 2
Fig. 2
Results of the linear regression models analyzing the association between HbA1c and inflammatory plasma proteins. The models were adjusted for sex, age, renal function, diabetes and BMI. P-values were Bonferroni-adjusted. Names of the markers are presented for all markers with Bonferroni-adjusted p-values below 0.05
Fig. 3
Fig. 3
Results of the linear regression models analyzing the association between inflammatory plasma proteins and admission glucose separately for patients with diabetes (green) and non-diabetes patients (orange). The models were adjusted for sex, age, renal function and BMI. P-values were Bonferroni-adjusted. Names of the markers are presented for all markers with Bonferroni-adjusted p-values below 0.05
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