Keywords
How to Cite
Abstract
Apolipoprotein A1 (ApoA1) is the main protein component of high-density lipoproteins (HDLs). Elevated levels of ApoA1 and HDL cholesterol in plasma are associated with a reduced risk of cardiovascular diseases (CVDs). In addition to its potential cardioprotective function, increasing HDL and ApoA1 also has antidiabetic properties. Given that diabetes mellitus (DM), along with obesity and age, is recognized as one of the few independent risk factors for severe course of COVID-19 induced by SARS Cov-2, we included measurements of ApoA1 and related biochemical indicators to the list of examinations in patients with COVID-19 and with and without diabetes mellitus. A clinical description of a fatal case of COVID-19 with DM, obesity, and a review of our own and literature data on the assessment of ApoA1 level, and related biochemical indicators in the blood of patients with COVID-19 are given. There was a fatal case: in a 72-year-old man with severe course of COVID-19, DM, and obesity who had an ApoA1 blood level of 0.317 g/L, nearly 6 times lower than normal (1.885 g/L), while a low-density lipoprotein (LDL) major protein of apolipoprotein B (ApoB) was 1.7 g/L (control 1.05±0.08 g/L), ApoB/ApoA1 index = 5.35 (control — 0.558; DM group — 0.952). Thus, the patient’s ApoB/ApoA1 index was critically high, which indicated possible further complications from the cardiovascular system. The level of the insulin receptor substrate 1 (IRS-1) in the blood plasma of the patient was significantly higher than in the blood of healthy people, the DM, and the COVID-19 groups with and without comorbidities. The possible causes of the severe course of COVID-19 and death were obesity and a high level of glucose in the patient’s blood.
References
Fritzen AM, Domingo-Espín J, Lundsgaard AM, Kleinert M, Israelsen I, Carl CS, et al. ApoA-1 improves glucose tolerance by increasing glucose uptake into heart and skeletal muscle independently of AMPKα2. Mol Metab. 2020 May;35:100949. doi: 10.1016/j.molmet.2020.01.013.
Rye KA, Barter PJ, Cochran BJ. Apolipoprotein A-I interactions with insulin secretion and production. Curr Opin Lipidol. 2016 Feb;27(1):8-13. doi: 10.1097/MOL.0000000000000253.
Соколова ЛК, Бельчіна ЮБ, Черв’якова СА, Пушкарьов ВВ, Фурманова ОВ, Ковзун ОІ, та ін. Рівень аполіпопротеїну А1 у хворих на цукровий діабет і коморбідні захворювання на тлі COVID-19. Ендокринологія. 2021;26(3):263-70 (Sokolova LK, Belchina YuB, Cherviakova SA, Pushkarev VV, Furmanova OV, Kovzun OI, et al. The level of apolipoprotein A1 in patients with diabetes mellitus and comorbid diseases on the background of COVID‑19. Endokrynologia. 2021;26(3):263-70. Ukrainian). doi:10.31793/1680-1466.2021.26-3.263.
Pushkarev VV, Sokolova LK, Cherviakova SA, Belchina YB, Kovzun OI, Pushkarev VM. Plasma apolipoproteins A1/B and oxLDL levels in patients with COVID-19 as possible markers of the disease. Cytol Genet. 2021;55(6):519-23. doi: 10.3103/S0095452721060116.
Cochran BJ, Ong KL, Manandhar B, Rye KA. High density lipoproteins and diabetes. Cells. 2021 Apr 9;10(4):850. doi: 10.3390/cells10040850.
Gao L, Zhang Y, Wang X, Dong H. Association of apolipoproteins A1 and B with type 2 diabetes and fasting blood glucose: a crosssectional study. BMC Endocr Disord. 2021 Apr 1;21(1):59. doi:10.1186/s12902-021-00726-5.
Tronko ND, Pushkarev VM, Sokolova LK, Pushkarev VV, Kovzun OI. Molecular mechanisms of pathogenesis of diabetes mellitus and its complications. Kyiv: Publishing house Medkniga, 2018. 264 p. Russian.
Retnakaran R, Ye C, Connelly PW, Hanley AJ, Sermer M, Zinman B. Serum apoA1 (Apolipoprotein A-1), insulin resistance, and the risk of gestational diabetes mellitus in human pregnancy — brief report. Arterioscler Thromb Vasc Biol. 2019 Oct;39(10):2192-7. doi: 10.1161/ATVBAHA.119.313195.
Zhu Z, Yang Y, Fan L, Ye S, Lou K, Hua X, et al. Low serum level of apolipoprotein A1 may predict the severity of COVID-19: A retrospective study. J Clin Lab Anal. 2021 Aug;35(8):e23911. doi: 10.1002/jcla.23911.
Potere N, Batticciotto A, Vecchié A, Porreca E, Cappelli A, Abbate A, et al. The role of IL-6 and IL-6 blockade in COVID-19. Expert Rev Clin Immunol. 2021 Jun;17(6):601-18. doi: 10.1080/1744666X.2021.1919086.
Sindhu S, Thomas R, Shihab P, Sriraman D, Behbehani K, Ahmad R. Obesity is a positive modulator of IL-6R and IL-6 expression in the subcutaneous adipose tissue: significance for metabolic inflammation. PLoS One. 2015 Jul 22;10(7):e0133494. doi: 10.1371/journal.pone.0133494.
Xu E, Pereira MMA, Karakasilioti I, Theurich S, Al-Maarri M, Rappl G, et al. Temporal and tissue-specific requirements for T-lymphocyte IL-6 signalling in obesity-associated inflammation and insulin resistance. Nat Commun. 2017 May 3;8:14803. doi: 10.1038/ncomms14803.
Tronko MD, Pushkarev VV, Sokolova LK, Cherviakova SA, Belchina YuB, Kovzun OI, et al. Effects of COVID-19, diabetes mellitus, and cardiovascular diseases on insulin receptor substrate-1 amount in the blood plasma of patients. Dopov. Nac. akad. nauk Ukr. 2021;5:114-7. doi:10.15407/dopovidi2021.05.114.
Chan SH, Kikkawa U, Matsuzaki H, Chen JH, Chang WC. Insulin receptor substrate-1 prevents autophagy-dependent cell death caused by oxidative stress in mouse NIH/3T3 cells. J Biomed Sci. 2012 Jul 12;19(1):64. doi: 10.1186/1423-0127-19-64.
Hakuno F, Fukushima T, Yoneyama Y, Kamei H, Ozoe A, Yoshihara H, et al. The novel functions of high-molecular-mass complexes containing insulin receptor substrates in mediation and modulation of insulin-like activities: emerging concept of diverse functions by IRS-associated proteins. Front Endocrinol (Lausanne). 2015 May 26;6:73. doi: 10.3389/fendo.2015.00073.
Reuveni H, Flashner-Abramson E, Steiner L, Makedonski K, Song R, Shir A, et al. Therapeutic destruction of insulin receptor substrates for cancer treatment. Cancer Res. 2013 Jul 15;73(14):4383-94. doi: 10.1158/0008-5472.CAN-12-3385.
Logette E, Lorin C, Favreau C, Oshurko E, Coggan JS, Casalegno F, et al. A machine-generated view of the role of blood glucose levels in the severity of COVID-19. Front Public Health. 2021 Jul 28;9:695139. doi: 10.3389/fpubh.2021.695139.