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Markers of inflammation and endothelial dysfunction are associated with incident cardiovascular disease, all-cause mortality, and progression of coronary calcification in type 2 diabetic patients with microalbuminuria.
- Source :
-
Journal of diabetes and its complications [J Diabetes Complications] 2016 Mar; Vol. 30 (2), pp. 248-55. Date of Electronic Publication: 2015 Nov 06. - Publication Year :
- 2016
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Abstract
- Background: We evaluated markers of inflammation and endothelial dysfunction and their associations with incident cardiovascular disease (CVD), all-cause mortality and progression of coronary artery calcium (CAC) in patients with type 2 diabetes (T2D) and microalbuminuria but without known coronary artery disease (CAD).<br />Methods: Prospective study including 200 patients receiving multifactorial treatment. Markers of inflammation (TNF-ɑ, sICAM-1, sICAM-3, hsCRP, SAA, IL-1β, IL-6, IL-8) and endothelial dysfunction (thrombomodulin, sVCAM-1, sICAM-1, sICAM-3, sE-selectin, sP-selectin) were measured at baseline. Adjustment included traditional CVD risk factors, and full adjustment additionally NT-proBNP and CAC. The "SQRT method" assessed CAC progression after 5.8years, and cut-point was an annualised difference >2.5.<br />Results: Occurrence of CVD (n=40) and all-cause mortality (n=26) was traced after 6.1years. In adjusted and fully adjusted Cox models, TNF-ɑ was a determinant of CVD and all-cause mortality (p≤0.007). Further, in adjusted and fully adjusted logistic regression, TNF-ɑ was related to CAC progression (p≤0.042). Of the other biomarkers, sICAM-3 and thrombomodulin were also associated with both endpoints (p≤0.046), IL-1β with CVD endpoints (p=0.021), and sVCAM-1 and sICAM-1 with all-cause mortality (p≤0.005). Higher composite z-scores including all markers of inflammation and endothelial dysfunction were associated with CVD and all-cause mortality (p≤0.008).<br />Conclusions: In patients with T2D and microalbuminuria without known CAD and receiving multifactorial treatment, biomarkers of inflammation and endothelial dysfunction were independently associated with CVD, all-cause mortality and CAC progression. Especially TNF-ɑ was a robust determinant, even after adjusting for NT-proBNP and CAC.<br /> (Copyright © 2016 Elsevier Inc. All rights reserved.)
- Subjects :
- Aged
Albuminuria blood
Albuminuria complications
Albuminuria mortality
Albuminuria physiopathology
Cardiovascular Diseases blood
Cardiovascular Diseases complications
Cardiovascular Diseases physiopathology
Cause of Death
Coronary Disease blood
Coronary Disease complications
Coronary Disease physiopathology
Diabetes Mellitus, Type 2 blood
Diabetes Mellitus, Type 2 complications
Diabetes Mellitus, Type 2 physiopathology
Diabetic Angiopathies blood
Diabetic Angiopathies mortality
Diabetic Nephropathies blood
Diabetic Nephropathies complications
Diabetic Nephropathies physiopathology
Disease Progression
Female
Humans
Incidence
Inflammation epidemiology
Male
Middle Aged
Vascular Calcification blood
Vascular Calcification complications
Vascular Calcification pathology
Biomarkers blood
Cardiovascular Diseases epidemiology
Coronary Disease epidemiology
Diabetes Mellitus, Type 2 mortality
Diabetic Nephropathies mortality
Endothelium, Vascular physiopathology
Inflammation blood
Vascular Calcification epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1873-460X
- Volume :
- 30
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of diabetes and its complications
- Publication Type :
- Academic Journal
- Accession number :
- 26651261
- Full Text :
- https://doi.org/10.1016/j.jdiacomp.2015.11.005