Abstract
BackgroundCathepsin S, as an adipokine, was reported to play a critical role in various disease, including atherosclerosis and diabetes. The present study aims to elucidate the relationship between circulating cathepsin S and cardiovascular disease (CVD) in patients with type 2 diabetes.MethodsA total of 339 type 2 diabetes individuals were enrolled in this cross-sectional community-based study. Basic information, medical and laboratory data were collected. Serum cathepsin S levels were assessed by ELISA.ResultsCompared to the CVD (−) group, levels of serum cathepsin S were significantly higher in the CVD (+) group, with the median 23.68 ng/ml (18.54–28.02) and 26.81 ng/ml (21.19–37.69) respectively (P < 0.001). Moreover, patients with acute coronary syndrome (ACS) had substantially higher levels of serum cathepsin S than those with stable angina pectoris (SAP), with the median 34.65 ng/ml (24.33–42.83) and 25.52 ng/ml (20.53–31.47) respectively (P < 0.01). The spearman correlation analysis showed that circulating cathepsin S was correlated with several cardiovascular risk factors. The univariate and multivariate logistic regression analysis revealed that circulating cathepsin S was an independent risk factor for CVD (all P < 0.001) after adjustment for potential confounders. Restricted cubic spline analysis showed circulating cathepsin S had a linearity association with CVD. In addition, receiver operating characteristic (ROC) curve analysis demonstrated that the area under curve (AUC) values of cathepsin S was 0.80 (95% CI: 0.75–0.84, P < 0.001), with the optimal cutoff value of cathepsin 26.28 ng/ml.ConclusionCirculating cathepsin S was significantly higher in the CVD (+) group than that in the CVD (−) one among type 2 diabetes. The increased serum cathepsin S levels were associated with increased risks of CVD, even after adjusting for potential confounders. Thus, cathepsin S might be a potential diagnostic biomarker for CVD.
Highlights
Cardiovascular disease (CVD) is the major complication and leading cause of morbidity and mortality in patients with type 2 diabetes [1]
There were no statistical difference in age, sex, smoking status, duration of type 2 diabetes, body mass index (BMI), waist circumference (WC), waist–hip ratio (WHR), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG), postprandial blood glucose (PBG), fasting insulin, HOMA-IR, HbA1c, total cholesterol (TC), HDL-C, blood urea nitrogen (BUN), serum creatine, eGFR and anti-diabetic drug usages between two groups
Univariate and multivariate logistic regression analysis revealed that circulating cathepsin S was an independent risk factor for CVD
Summary
Cardiovascular disease (CVD) is the major complication and leading cause of morbidity and mortality in patients with type 2 diabetes [1]. Previous studies have revealed that cathepsin S plays a critical role in various diseases, including atherosclerosis [4], abdominal aortic aneurysm [5], cancer [6], obesity [7] and type 2 diabetes [8]. Liu et al reported that there is a significant increase of circulating cathepsin S level in both diabetes and atherosclerosis [9]. Cathepsin S, as an adipokine, was reported to play a critical role in various disease, including atherosclerosis and diabetes. The present study aims to elucidate the relationship between circulating cathepsin S and cardiovascular disease (CVD) in patients with type 2 diabetes
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