Abstract
BackgroundThe prevalence of peripheral artery disease (PAD) is obviously increased in patients with diabetes. Existing evidence shows that cysteine-rich angiogenic inducer 61 (Cyr61), a 40-kD secreted protein, plays important roles in regulating cellular physiological processes. Recent studies have demonstrated a significant correlation between serum Cyr61 and atherosclerosis. However, the relationship between Cyr61 levels and PAD in patients with type 2 diabetes (T2DM) remains obscure.MethodsData from a total of 306 subjects with T2DM were cross-sectionally analysed. The extent of PAD was determined by using the Fontaine classification, which defines four stages. We measured serum Cyr61 concentrations by ELISA in subjects with and without PAD at Fontaine’s stage II, III, or IV. Logistic regression models were used to examine the independent association of Cyr61 with PAD.ResultsOut of the 306 subjects enrolled, 150 were free from PAD, while 156 had clinically significant PAD. In subjects with PAD, the prevalences of Fontaine classification stages II, III and IV were 48.7%, 32.1%, and 19.2%, respectively. Patients with more advanced PAD had significantly higher Cyr61 (P for trend < 0.001). The prevalence of PAD on the basis of severity increased with increasing Cyr61 quartiles (all P values for trends < 0.001), and the severity of PAD was positively correlated with Cyr61 quartiles (r = 0.227, P = 0.006). The association of Cyr61 levels with PAD remained after adjusting for major risk factors in a logistic regression analysis.ConclusionsOur results demonstrated that Cyr61 was significantly increased in PAD patients with T2DM and that Cyr61 levels were positively associated with disease severity. Cyr61 could be a promising biomarker and further studies are needed to assess its clinical utility.
Highlights
The prevalence of peripheral artery disease (PAD) is obviously increased in patients with diabetes
Recent studies demonstrated that cysteine-rich angiogenic inducer 61 (Cyr61) levels were independently associated with 30-day mortality in patients with acute heart failure (AHF) and coronary heart disease (CAD) [18], and could be a potential marker of myocardial ischemic injury and prognosis in patients with acute coronary syndrome (ACS) [9, 19]
Among the 306 subjects with diabetes enrolled in the study, 156 were included as PAD, and 150 as no PAD
Summary
The prevalence of peripheral artery disease (PAD) is obviously increased in patients with diabetes. Previous studies have found that some members of the cellular communication network (CCN) family are highly expressed in atherosclerotic plaques, contributing to the development of cardiovascular and cerebrovascular diseases and peripheral arterial diseases [5, 6]. Cysteine-rich angiogenic inducer 61 (Cyr61), belonging to the CCN family, is a 40 kD secreted extracellular matrix (ECM)- related signalling protein that can regulate cell proliferation, adhesion, differentiation and extracellular matrix production [7,8,9]. Recent studies demonstrated that Cyr levels were independently associated with 30-day mortality in patients with acute heart failure (AHF) and coronary heart disease (CAD) [18], and could be a potential marker of myocardial ischemic injury and prognosis in patients with acute coronary syndrome (ACS) [9, 19]. The link between circulating Cyr and PAD in patients with diabetes has not yet been established
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