Abstract
Aims To assess whether circulating 25-hydroxyvitamin D3 (25OHD) and mineral metabolism-related factors (serum phosphate, calcium, and parathormone) are associated with subclinical carotid atherosclerosis (SCA), defined as the presence of carotid atherosclerotic plaques (main study outcome), in patients with type 2 diabetes mellitus (T2DM) without kidney disease or previous cardiovascular disease. Methods We undertook a post hoc analysis of a cross-sectional study in adults with T2DM in whom we evaluated SCA. A total of 303 subjects with T2DM were included. Clinical variables and carotid ultrasound imaging were obtained. Results We found no association of 25OHD with the presence of SCA. However, calcium phosphate (CaP; mg2/dL2) product was positively associated with the presence of carotid plaques (ORadj = 1.078; 95% CI: 1.017–1.142). An inverse association was observed between higher levels of 25OHD (≥30 ng/mL versus <20 ng/mL concentrations) and common carotid intima-media thickness (cIMT; mm) (βadj ± SE = −0.055 ± 0.024). We conclude that the CaP product is independently associated with the presence of established subclinical carotid atherosclerosis in patients with T2DM.
Highlights
Patients with type 2 diabetes mellitus (T2DM) are at 2- to 4-fold higher risk of cardiovascular mortality compared with nondiabetic subjects [1]
Subjects with SCA showed increased values of common carotid intimamedia thickness, which is an early measure of subclinical carotid atherosclerosis (0.83 versus 0.73 mm; p < 0 001)
25OHD and PTH were not associated with the presence of plaques, we found a positive association between the calcium phosphate (CaP) product and the presence of SCA (OR = 1.078; 95% confidence interval (95% CI) = 1.017–1.142; p = 0 012) (Table 2)
Summary
Patients with type 2 diabetes mellitus (T2DM) are at 2- to 4-fold higher risk of cardiovascular mortality compared with nondiabetic subjects [1]. There is an increased burden of atherosclerotic plaques in patients with T2DM well before the appearance of cardiovascular events [5, 6]. The presence of carotid plaques is a stronger predictor of future events than carotid intimamedia thickness [7]. In type 2 diabetic subjects, the presence of carotid plaques strongly predicts future cardiovascular events [6]. Clinical prediction of cardiovascular disease in type 2 diabetes is still an important challenge. Additional biomarkers for improving cardiovascular risk prediction have not yet been proved to be helpful in the clinical setting [8]. The identification of new biomarkers applicable to clinical practice is a current challenge to improve risk evaluation and clinical outcomes
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