DefinePK

Abstract

Background & objective: Atherosclerosis (AS) is a chronic inflammatory disease characterized by the accumulation of lipids, cholesterol, and other substances on the arterial walls. This leads to plaque formation, which can narrow and harden the arteries, leading to reduced blood flow. We aimed to study the association between sub-clinical/ clinical AS and serum levels of Midkine (MK) in patients.
Materials and Methods: This cross-sectional study included 90 male participants aged 20-60 years (mean age 33.00 ± 6.131 years). Participants were divided into two groups: 45 patients with clinical coronary AS (mean age 34.50 ± 4.949 years) and 45 patients with subclinical coronary AS (mean age 32.25 ± 7.228 years). The serum Midkine, insulin, and fasting blood glucose were calculated using an Enzyme-Linked Immunosorbent Assay (ELISA), whereas HbA1C measurement was conducted by a spectrophotometer.
Results: The results demonstrated a highly significant elevation (P ≤ 0.01) in Midkine levels among patients with clinical AS (2.728 ± 0.411) compared to those with subclinical AS (1.056 ± 0.160). Additionally, patients with clinical AS exhibited significantly higher levels (P ≤ 0.01) of multiple metabolic parameters compared to the subclinical group, including random glucose, insulin, and HbA1C. Lipid profile analysis revealed significant increases (P ≤ 0.01) in total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL), and very low-density lipoprotein (VLDL) in the clinical AS group relative to the subclinical AS group.
Conclusion: This study highlighted a significant link between elevated serum MK levels and atherosclerosis risk factors, including diabetes mellitus and increased total and LDL cholesterol. C-peptide, insulin, HOMA-IR can be regarded as the main indicators of diabetic mellitus markers. Therefore, MK can be considered early diagnosis and prognosis biomarker for atherosclerosis.
Abbreviations: AS: Atherosclerosis, DM: Diabetes mellitus, LDL: low-density lipoprotein, MK: Midkine, TC: total cholesterol, TG: triglycerides, VLDL: very low-density lipoprotein, HOMA-IR: Homeostatic Model Assessment of Insulin Resistance
Keywords: Cholesterol; Coronary Atherosclerosis; Diabetes Mellitus; HOMA-IR; HbA1C; Lipoprotein; Midkine; Triglycerides
Citation: Khudair ZH, Yousif AC, Jaafar AQ. Midkine (MK) as a novel biomarker of clinical-subclinical coronary atherosclerosis and related to diabetes mellitus: clinical applications. Anaesth. pain intensive care 2025;29(6):559-566. DOI: 10.35975/apic.v29i6.2915
Received: June 10, 2025; Revised: Jul 16, 2024; Accepted: Jul 24, 2025