Assessment of serum sirtuin 1 levels in type 2 diabetes mellitus with coronary artery disease patients

Background and objective. Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by hyperglycemia and insulin deficiency, and is accompanied by multiple complications, including cardio­vascular disease. Silent information regulator 1 (SIRT1) plays a role in diverse physiological and pathological processes. This study aimed to evaluate serum SIRT1 levels in patients with T2DM and in those with T2DM and coronary artery disease (CAD), and to explore their correlation with cardiovascular risk factors. Methods. A case–control study was conducted on 225 participants, divided into three groups (n = 75 each): healthy controls, T2DM, and T2DM with CAD. Serum SIRT1 levels were measured by ELISA, along with standard biochemical and cardiac markers. Data were analyzed using ANOVA with post-hoc tests, Pearson correlations, multiple regression, and ROC analysis. Results. Mean serum SIRT1 levels were 1.23 ng/mL in controls, 2.07 ng/mL in T2DM, and 5.77 ng/mL in T2DM-CAD patients (p < 0.001). ROC analysis identified a cut-off value of 3.4 ng/mL, with 68% sensitivity, 93.3% specificity, and 80.7% accuracy for detecting CAD in T2DM patients. Serum SIRT1 levels were significantly higher in T2DM-CAD patients compared with both controls and T2DM patients (p < 0.001). SIRT1 levels showed positive correlations with glycemic and lipid parameters, and a negative correlation with CK-MB in controls and T2DM patients. In the T2DM-CAD group, SIRT1 levels correlated positively with most biochemical and cardiac markers, except HDL-cholesterol. Conclusion. Serum SIRT1 levels were significantly elevated in T2DM patients with CAD, suggesting a potential role as a non-invasive biomarker for cardiovascular risk stratification in diabetes. Further longitudinal studies are needed to validate SIRT1 as a biomarker.