Impact of biomarkers for endothelial dysfunction and procoagulant state on 10-year cardiovascular risk in Type 2 diabetes1

Natarajan, Arun; Marshall, Sally M.; Kesteven, Patrick; McComb, Janet M.; Rutter, Martin K.

doi:10.1111/j.1464-5491.2011.03311.x

Cited by 9 publications

(6 citation statements)

References 24 publications

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“…These observations may be explained by common features in the pathophysiologies of CKD and type 2 diabetes. Risk factors for cardiovascular events such as increased levels of procoagulant biomarkers, anemia and endothelial dysfunction have been shown to be associated with both reduced kidney function [ 40 - 42 ] and type 2 diabetes [ 43 - 45 ]. These factors may act synergistically to increase the risk of cardiovascular events compared with CKD or type 2 diabetes alone.…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular events and all-cause mortality in a cohort of 57,946 patients with type 2 diabetes: associations with renal function and cardiovascular risk factors

Soriano

Johansson

Stefánsson

et al. 2015

Cardiovasc Diabetol

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BackgroundDiabetes and chronic kidney disease (CKD) are independent predictors of death and cardiovascular events and their concomitant prevalence has increased in recent years. The aim of this study was to characterize the effect of the estimated glomerular filtration rate (eGFR) and other factors on the risk of death and cardiovascular events in patients with type 2 diabetes.MethodsA cohort of 57,946 patients with type 2 diabetes who were aged 20–89 years in 2000–2005 was identified from The Health Improvement Network, a UK primary care database. Incidence rates of death, myocardial infarction (MI), and ischemic stroke or transient ischemic attack (IS/TIA) were calculated overall and by eGFR category at baseline. eGFR was calculated using the Modification of Diet in Renal Disease (MDRD) study equation. Death, MI and IS/TIA cases were detected using an automatic computer search and IS/TIA cases were further ascertained by manual review of medical records. Hazard ratios (HRs) and their corresponding 95% confidence intervals (CIs) for death, MI, and IS/TIA associated with eGFR category and other factors were estimated using Cox regression models adjusted for potential confounders.ResultsOverall incidence rates of death (mean follow-up time of 6.76 years), MI (6.64 years) and IS/TIA (6.56 years) were 43.65, 9.26 and 10.39 cases per 1000 person-years, respectively. A low eGFR (15–29 mL/min) was associated with an increased risk of death (HR: 2.79; 95% CI: 2.57–3.03), MI (HR: 2.33; 95% CI: 1.89–2.87) and IS/TIA (HR: 1.77; 95% CI: 1.43–2.18) relative to eGFR ≥ 60 mL/min. Other predictors of death, MI and IS/TIA included age, longer duration of diabetes, poor control of diabetes, hyperlipidemia, smoking and a history of cardiovascular events.ConclusionsIn patients with type 2 diabetes, management of cardiovascular risk factors and careful monitoring of eGFR may represent opportunities to reduce the risks of death, MI and IS/TIA.Electronic supplementary materialThe online version of this article (doi:10.1186/s12933-015-0204-5) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Cardiovascular events and all-cause mortality in a cohort of 57,946 patients with type 2 diabetes: associations with renal function and cardiovascular risk factors

Soriano

Johansson

Stefánsson

et al. 2015

Cardiovasc Diabetol

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“…This was not, however, accompanied by a significant change in urinary excretion of albumin. Soluble E-selectin together with a coagulation factor, XIIa, has been associated with ten-year macrovascular events in subjects with T2D [41]. Poor vitamin D status-related endothelial dysfunction in diabetes may be partly mediated by nuclear factor κ-B (NF-κB)-linked inflammation [42] and endothelial progenitor cell depletion [43].…”

Section: Discussionmentioning

confidence: 99%

Regular consumption of vitamin D-fortified yogurt drink (Doogh) improved endothelial biomarkers in subjects with type 2 diabetes: a randomized double-blind clinical trial

Shab-Bidar

Neyestani

Djazayery

et al. 2011

BMC Med

130

136

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BackgroundEndothelial dysfunction has been proposed as the underlying cause of diabetic angiopathy that eventually leads to cardiovascular disease, the major cause of death in diabetes. We recently demonstrated the ameliorating effect of regular vitamin D intake on the glycemic status of patients with type 2 diabetes (T2D). In this study, the effects of improvement of vitamin D status on glycemic status, lipid profile and endothelial biomarkers in T2D subjects were investigated.MethodsSubjects with T2D were randomly allocated to one of the two groups to receive either plain yogurt drink (PYD; containing 170 mg calcium and no vitamin D/250 mL, n1 = 50) or vitamin D3-fortified yogurt drink (FYD; containing 170 mg calcium and 500 IU/250 mL, n2 = 50) twice a day for 12 weeks. Anthropometric measures, glycemic status, lipid profile, body fat mass (FM) and endothelial biomarkers including serum endothelin-1, E-selectin and matrix metalloproteinase (MMP)-9 were evaluated at the beginning and after the 12-week intervention period.ResultsThe intervention resulted in a significant improvement in fasting glucose, the Quantitative Insulin Check Index (QUICKI), glycated hemoglobin (HbA1c), triacylglycerols, high-density lipoprotein cholesterol (HDL-C), endothelin-1, E-selectin and MMP-9 in FYD compared to PYD (P < 0.05, for all). Interestingly, difference in changes of endothelin-1, E-selectin and MMP-9 concentrations in FYD compared to PYD (-0.35 ± 0.63 versus -0.03 ± 0.55, P = 0.028; -3.8 ± 7.3 versus 0.95 ± 8.3, P = 0.003 and -2.3 ± 3.7 versus 0.44 ± 7.1 ng/mL, respectively, P < 0.05 for all), even after controlling for changes of QUICKI, FM and waist circumference, remained significant for endothelin-1 and MMP-9 (P = 0.009 and P = 0.005, respectively) but disappeared for E-selectin (P = 0.092). On the contrary, after controlling for serum 25(OH)D, the differences disappeared for endothelin-1(P = 0.066) and MMP-9 (P = 0.277) but still remained significant for E-selectin (P = 0.011).ConclusionsAmeliorated vitamin D status was accompanied by improved glycemic status, lipid profile and endothelial biomarkers in T2D subjects. Our findings suggest both direct and indirect ameliorating effects of vitamin D on the endothelial biomarkers.Trial registrationClinicalTrials.gov: NCT01236846

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“…8 However, an adverse association between E-selectin concentration and macrovascular events, including stroke, has recently been reported among type 2 diabetic patients, with a hazard ratio per 1-U increase in log E-selectin of 2.3 over 10 years of follow-up. 25 Furthermore, a case-control study, including 200 stroke patients and 205 community controls, observed a 3.4-fold and 7.9-fold increased likelihood of ischemic stroke among individuals in the third and fourth quartiles of the E-selectin distribution. 26 The concurrent examination of significant biomarkers in a single multivariable model allowed us to obtain a more parsimonious set of biomarkers of potential importance for ischemic stroke risk prediction.…”

Section: Associationsmentioning

confidence: 99%

Multiple Biomarkers for the Prediction of Ischemic Stroke

Prugger

Luc

Haas

et al. 2013

ATVB

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Objective-To simultaneously evaluate 14 biomarkers from distinct biological pathways for risk prediction of ischemic stroke, including biomarkers of hemostasis, inflammation, and endothelial activation as well as chemokines and adipocytokines. Methods and Results-The Prospective Epidemiological Study on Myocardial Infarction (PRIME) is a cohort of 9771 healthy men 50 to 59 years of age who were followed up over 10 years.

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Impact of biomarkers for endothelial dysfunction and procoagulant state on 10-year cardiovascular risk in Type 2 diabetes1

Abstract: In our study, soluble E-selectin and factor XIIa were significantly related to 10-year incident macrovascular events in patients with Type 2 diabetes. These preliminary findings call for replication in larger studies.

Cited by 9 publications

References 24 publications

Cardiovascular events and all-cause mortality in a cohort of 57,946 patients with type 2 diabetes: associations with renal function and cardiovascular risk factors

Cardiovascular events and all-cause mortality in a cohort of 57,946 patients with type 2 diabetes: associations with renal function and cardiovascular risk factors

Regular consumption of vitamin D-fortified yogurt drink (Doogh) improved endothelial biomarkers in subjects with type 2 diabetes: a randomized double-blind clinical trial

Multiple Biomarkers for the Prediction of Ischemic Stroke

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