scholarly journals Carotid Artery Disease in Subjects with Type 2 Diabetes: Risk Factors and Biomarkers

2021 ◽  
Vol 11 (1) ◽  
pp. 72
Author(s):  
Vadim V. Klimontov ◽  
Elena A. Koroleva ◽  
Rustam S. Khapaev ◽  
Anton I. Korbut ◽  
Alexander P. Lykov
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Carotid Artery ◽  
Carotid Artery Disease ◽  
Univariate Analysis ◽  
Diabetes Duration ◽  
Matrix Metalloproteinase 2 ◽  
Male Sex ◽  
Artery Disease

Carotid atherosclerosis (CA) and, especially, carotid artery stenosis (CAS), are associated with a high risk of cardiovascular events in subjects with type 2 diabetes (T2D). In this study, we aimed to identify risk factors and biomarkers of subclinical CA and CAS in T2D individuals. High-resolution ultrasonography of carotid arteries was performed in 389 patients. Ninety-five clinical parameters were evaluated, including diabetic complications and comorbidities; antihyperglycemic, hypolipidemic, and antihypertensive therapy; indices of glycemic control and glucose variability (GV); lipid panels; estimated glomerular filtration rate (eGFR); albuminuria; blood cell count; and coagulation. Additionally, serum levels of calponin-1, relaxin, L-citrulline, and matrix metalloproteinase-2 and -3 (MMP-2, -3) were measured by ELISA. In univariate analysis, older age, male sex, diabetes duration, GV, diabetic retinopathy, chronic kidney disease, coronary artery disease, peripheral artery disease, and MMP-3 were associated with subclinical CA. In addition to these factors, long-term arterial hypertension, high daily insulin doses, eGFR, and L-citrulline were associated with CAS. In multivariate logistic regression, age, male sex, BMI, GV, and eGFR predicted CA independently; male sex, BMI, diabetes duration, eGFR, and L-citrulline were predictors of CAS. These results can be used to develop screening and prevention programs for CA and CAS in T2D subjects.

Effect of metformin treatment in patients with type 2 diabetes with respect to glyoxalase 1 activity in atherosclerotic lesions

VASA ◽  
2019 ◽  
Vol 48 (2) ◽  
pp. 186-192 ◽  
Author(s):  
Andreas S. Peters ◽  
Markus Wortmann ◽  
Thomas H. Fleming ◽  
Peter P. Nawroth ◽  
Thomas Bruckner ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Carotid Artery ◽  
Carotid Artery Disease ◽  
Microvascular Complications ◽  
Clinical History ◽  
Metformin Treatment ◽  
Protein Levels ◽  
Atherosclerotic Lesions ◽  
Artery Disease

Abstract. Background: The enzyme glyoxalase1 (GLO1) is the main opponent in the degradation of the reactive metabolite methylglyoxal (MG), which by glycation of macromolecules is involved in atherogenesis. Reduced GLO1-activity in atherosclerotic tissue is known to be associated with diabetes. It has been shown that treatment of patients with type 2 diabetes with metformin leads to increased GLO1-activity in peripheral-blood-cells. The aim of this study was to evaluate whether metformin treatment increases GLO1-activity in atherosclerotic lesions of patients with type 2 diabetes. Patients and methods: Patients with type 2 diabetes and carotid artery disease were included into the study prospectively. Type of diabetes-medication was documented upon admission along with demographic and clinical history. Using shock frozen endarterectomy-derived carotid artery plaques, GLO1-activity as well as protein expression was measured by a spectophotometric assay and western-blotting respectively. Results: 33 patients (76 % male, mean age 71 years) were included into the study and were divided according to treatment with metformin or not (15 vs. 18 patients). GLO1-activity was increased by the factor 1.36 when treated with metformin – however, not significantly (0.86 vs. 0.63 U/mg, p = 0.056). Normalisation of GLO1-activity onto GLO1-expression level lead to a significant increase by more than twofold (8.48 vs. 3.85, p = 0.044) while GLO1-protein levels did not differ significantly. GLO1-activity correlated positively with increasing HbA1c, especially under metformin treatment. Conclusions: Treatment with metformin in patients with type 2 diabetes is associated with enhanced GLO1-activity in atherosclerotic lesions. Regarding the macro- and microvascular complications in these patients further studies are needed to gain more insight into the effect of metformin on the GLO/MG system.

scholarly journals Contemporary (2019) prevalence of cardiovascular disease in adults with type 2 diabetes in Brazil: the cross-sectional CAPTURE study

2022 ◽  
Vol 14 (1) ◽  
Author(s):  
Sérgio Vencio ◽  
André Gustavo Daher Vianna ◽  
Mariana Arruda Camara Ferreira da Silva ◽  
Dalton Bertolim Precoma
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Carotid Artery ◽  
Carotid Artery Disease ◽  
Patient Characteristics ◽  
Cross Sectional ◽  
Specialized Care ◽  
Glucagon Like Peptide 1 ◽  
Artery Disease

Abstract Background Type 2 diabetes (T2D) is a known risk factor for cardiovascular disease (CVD), and CVD is a major cause of mortality in patients with T2D. The CAPTURE study investigated the contemporary (2019) prevalence of established CVD in adults with T2D around the world. We report the findings from Brazil. Methods The multinational, non-interventional, cross-sectional CAPTURE study was conducted across 13 countries from five continents. The current manuscript explores data for the CAPTURE study sample in Brazil. Standardized demographic and clinical data were collected from adults with T2D aged ≥ 18 years attending a single routine healthcare visit in primary or specialized care between December 2018 and September 2019. Data were analyzed descriptively. Results Data from 912 adults with T2D were collected in the CAPTURE study in Brazil, with 822 patients from primary care and 90 patients from specialized care. Median (interquartile range [IQR]) patient characteristics were as follows: age 64 years (57; 71), diabetes duration 11 years (6; 19), glycated hemoglobin 7.7% (6.7; 9.1), and body mass index 29.5 kg/m2 (26.4; 33.5); 59% were female. The CVD prevalence and atherosclerotic CVD prevalence in the Brazil sample were 43.9% (95% confidence interval [CI] 40.9; 46.8) and 37.6% (95% CI 34.7; 40.5), respectively. The majority of patients with CVD had atherosclerotic CVD (85.8%). For the specific CVD subtypes, coronary heart disease prevalence was 27.9% (95% CI 25.2; 30.5), heart failure was 12.4% (95% CI 10.4; 14.4), cerebrovascular disease was 8.7% (95% CI 6.8; 10.5), and carotid artery disease was 3.4% (95% CI 2.3; 4.5). Glucagon-like peptide-1 receptor agonists and/or sodium-glucose co-transporter-2 inhibitors with proven cardiovascular benefit were prescribed to 15.5% of patients with CVD, compared with 18.4% of patients without CVD. Conclusions CAPTURE was the first multinational, standardized study to provide contemporary data on CVD prevalence in adults with T2D in Brazil, and it demonstrated that almost one in two adults with T2D had established CVD. Except for carotid artery disease, the prevalence of all CVD subtypes in adults with T2D in Brazil appeared higher than the global CAPTURE prevalence. Trial registration NCT03786406, NCT03811288

scholarly journals Endothelin-1 predicts incident diabetic peripheral neuropathy in Type 2 Diabetes: a cohort study

2020 ◽  
Vol 182 (4) ◽  
pp. 429-438
Author(s):  
Sharon Li Ting Pek ◽  
Su Chi Lim ◽  
Keven Ang ◽  
Pek Yee Kwan ◽  
Wern Ee Tang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Cohort Study ◽  
Peripheral Neuropathy ◽  
Diabetic Peripheral Neuropathy ◽  
Diabetes Duration ◽  
Endothelin 1

Introduction Diabetic peripheral neuropathy (DPN) is a common microvascular complication in patients with type 2 diabetes (T2D). Apart from hyperglycemia, few modifiable risk factors have been identified. Endothelin-1 is a potent vasoconstrictor peptide, implicated in the causal pathway of microangiopathy. We investigated whether baseline plasma endothelin-1 and other metabolic and vascular risk factors predicted the incidence of DPN. Design This is a 3-year observational, cohort study. Methods In patients with T2D (n = 2057), anthropometric data, fasting blood, and urine were collected for biochemistry and urine albumin/creatinine measurements. Forearm cutaneous endothelial reactivity was assessed by iontophoresis and laser Doppler flowmetry/imaging. Measurements were repeated on follow-up. Incident DPN was considered present if an abnormal finding in monofilament (<8 of 10 points) or neurothesiometer testing was ≥25 volts on either foot at 3-year follow-up, but normal at baseline. Plasma endothelin-1 was assessed by ELISA. Results At baseline, mean age of patients was 57.4 ± 10.8 years old and prevalence of DPN was 10.8%. Of the 1767 patients without DPN, 1250 patients returned for follow-up assessment ((2.9 ± 0.7) years), with a 10.7% incidence of DPN. Patients with incident DPN had significantly higher baseline endothelin-1 (1.43 (1.19–1.73) vs 1.30 (1.06–1.63)) pg/mL, P < 0.0001. Multivariable Cox proportional hazards ratio showed a 1-s.d. increase in log endothelin-1 (adjusted HR: 4.345 (1.451–13.009), P = 0.009), systolic blood pressure (per 10-unit) (adjusted HR: 1.107 (1.001–1.223), P = 0.047) and diabetes duration (adjusted HR: 1.025 (1.004–1.047), P = 0.017) predicted incident DPN, after adjustment for glycemic control, eGFR, albuminuria, peripheral arterial disease and retinopathy status. Conclusion Higher baseline endothelin-1, blood pressure and diabetes duration were significant and independent predictors for incident DPN. Validation of our findings in independent cohorts and molecular mechanistic studies will help better our understanding on the role of endothelin-1 in DPN.

Abdominal aortic calcification is associated with morbidity of cardiovascular disease and Fib-4 index in type 2 diabetes: a retrospective cross-sectional study

2020 ◽  
Author(s):  
Yu Togashi ◽  
Jun Shirakawa ◽  
Daisuke Miyashita ◽  
Mayu Kyohara ◽  
Tomoko Okuyama ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Cross Sectional Study ◽  
Abdominal Aortic Calcification ◽  
Cross Sectional ◽  
Abdominal Aortic ◽  
Artery Disease

Abstract Background: Little is known about the association between abdominal aortic calcification (AAC) and the risk of cardiovascular disease (CVD) among patients with diabetes. This study evaluated the cross-sectional association between AAC and CVD morbidity in patients with type 2 diabetes. Methods: This retrospective cross-sectional study enrolled 285 inpatients with type 2 diabetes. The lateral view of an abdominal X-ray image obtained while each subject was in a standing position was examined, and the AAC score and AAC length, corresponding to the area of calcific deposits in the anterior and posterior aortic wall for the L1-4 and L1-5 regions, respectively, were measured. The associations between the AAC scores and lengths and the presence of coronary artery disease (CAD), cerebral infarction (CI), and peripheral artery disease (PAD) were then assessed. The correlation between the AAC grades and other clinical factors were also evaluated. Results: The degree of AAC was significantly correlated with a higher prevalence of CAD and CI but not PAD after adjustments for cardiovascular risk factors. The AAC score was inversely correlated with BMI, and both the AAC score and the AAC length were correlated with the Fib-4 index; these correlations persisted after adjustments for cardiovascular risk factors and BMI, although AAC was not associated with ultrasonography-diagnosed fatty liver. Conclusion: AAC is associated with CAD and CI morbidity in patients with type 2 diabetes. AAC grading also predicts the Fib-4 index, a hepatic fibrosis marker, suggesting a novel potential predictor of liver disease that is independent of cardiovascular risk factors and obesity.

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