ABSTRACT
Objective To investigate the correlation of serum irisin level with insulin resistance and left ventricular remodeling after PCI in patients with ST-segment elevation myocardial infarction(STEMI)without diabetes.Methods A total of 485 STEMI patients without diabetes who received emergency PCI in our hospital from January 2017 to August 2020 were recruited in this study.According to the quartile values of baseline serum irisin levels,they were divided into low(＜0.31 mg/L,n=161),medium(0.31-0.97 mg/L,n=150),and high irisin groups(＞0.97 mg/L,n=174).Serum irisin level was measured with ELISA and insulin resistance was assessed by homeostasis model.During a follow-up of 12 months,the relationship between serum irisin level and echocardiographic parameters was evaluated.Results Compared with the baseline irisin level,the level reached a peak of at 8 h after PCI,and decreased a minimum at 3 d after surgery,with statistical differences(P＜0.01).The low irisin group had significantly higher BMI,diastolic blood pressure,fasting blood glucose,fasting insulin,TG,cTnI peak and NT-proBNP levels,but youn-ger age when compared with the medium irisin group and the high irisin group(P＜0.05).Obvi-ously higher diastolic blood pressure,fasting insulin,TG,cTnI peak and NT-proBNP levels were observed in the medium irisin group than the high irisin group(P＜0.05).Pearson correlation analysis showed that baseline serum irisin level was negatively correlated with HOMR-IR,ΔLVEDD,ΔLVESD,ΔLVEDVi and ΔLVESVi(r=-0.338,r=-0.172,r=-0.164,r=-0.154,r=-0.167,P＜0.01).Multiple linear regression analysis indicated that after further ad-justment for impaired glucose tolerance and BMI,low irisin level was still independently associat-ed with ΔLVEDD(P＜0.01).Conclusion Baseline irisin level in STEMI patients without diabetes is correlated with insulin resistance and subsequent poor left ventricular remodeling,and is expec-ted to be a predictor of left ventricular remodeling after PCI.