In individuals with unstable angina, insulin resistance has multiple connecting arms

Introduction
Insulin resistance (IR) and unstable angina (UA) are two global public health threats. When UA patients have comorbid IR, they would suffer from serious complications, including atherosclerosis and dysregulation of some important pathways.

Aim of the research
The present study used biomarkers of multiple pathways for the detection of IR in UA patients.

Material and methods
We examined biomarkers of lipid profile, IR, endogenous opioids (β-endorphin (βEP) and µ-opioid receptor (MOR)) and vitamin D₃ in patients with IR (UA + IR) (n = 35), without IR (UA-IR) (n = 41), and healthy controls (n = 45).

Results
The triglycerides (TG), total cholesterol, very low-density lipoprotein cholesterol, HOMA index of β-cell function percentage (HOMA2%B), HOMA index of sensitivity (HOMA2%S), and Homeostatic Model Assessment of Insulin Resistance Index (HOMA2IR) were significantly different between the three diagnostic groups. There was a significant increase in uric acid, blood urea, creatinine, low-density lipoprotein cholesterol, κ-opioid receptor (KOR), endomorphin 2 (EM2), Castelli’s Risk Index I (CRI-I), Castelli’s Risk Index II (CRI-II), AG, Atherogenic Index of Plasma (AIP), interleukin (IL) 6 (IL-6), IL-10, IL-10/IL-6 ratio, βEP, MOR, and fasting blood sugar. Toll-like receptor 4 (TLR4) is higher in patient groups than controls, while there is a significant decrease in estimated glomerular filtration rate (eGFR), vitamin D (VD), βEP/MOR, and high-density lipoprotein cholesterol in both patient groups compared with the control group.

Conclusions
The presence of IR state in UA patients is associated with various changes in serum biomarkers of some systemic arms.