Mediating Effect of C-reactive Protein and Aspartate Aminotransferase on Diabetes Mellitus and Myocardial Infarction Risk

Abstract

Background: The relationship between diabetes and myocardial infarction has always been the focus of research, but it is not clear whether the DM-MI association is direct or mediated by other factors. Our hypothesis is that part of the risk of MI in DM patients may be mediated by CRP and AST. We examined this hypothesis in the mediation analysis and tried to assess the extent to which CRP and AST could explain the MI risk caused by DM.Methods: This case-control study was conducted on 130 patients with MI and 130 patients with no-MI. We compared the relevant biochemical indicators of MI and no-MI patients, and applied mediation analysis to test the association of CRP and AST with DM-MI Potential adjustment effect.Results: The study found that individuals who suffered MI were more likely to have DM as compared with Non-MI (OR = 2.117, 95%CI = 1.130-4.195, P = 0.020), and CRP and AST are positively correlated with the occurrence of MI, For every unit increase in CRP and AST levels, the risk level of MI Significantly increased by 1%, 3.1% respectively. The direct effect of DM and MI is 0.847, the mediating effect of CRP is 7.69% of the total effect, and the mediating effect of AST is 52.79% of the total effect. The mediation effect of the CRP-AST path is 0.386, accounting for 12.36% of the total effect. In the mediation model we verified, CRP and AST play a part of the mediation effect between DM with MI, and the total mediation effect accounts for 72.84%.Conclusions: CRP and AST play an important role in the risk of DM-induced MI. This provides evidence for the mechanism and is of great significance for the exploration of therapeutic targets.