Abstract
BackgroundHeat shock protein 27 (HSP27) has been proposed as a vital protective factor in atherosclerosis. The objective of the present study was to evaluate the association between circulating HSP27 and carotid intima–media thickness (IMT) in individuals with type 2 diabetes and to determine whether HSP27 represents an independent marker of subclinical atherosclerosis in this patient population.MethodsWe performed a cross-sectional community-based study in 186 Chinese subjects with a median duration of type 2 diabetes of 8.2 years who underwent ultrasound carotid IMT measurement. Serum HSP27 levels were assessed by ELISA.ResultsSerum HSP27 levels were significantly higher in the IMT (+, > 1.0 mm) group than in the IMT (−, ≤1.0 mm) group, with the median values of 8.80 ng/mL (5.62–12.25) and 6.93 ng/mL (4.23–9.60), respectively (P = 0.006). The discriminative value of HSP27 to evaluate IMT was 7.16 ng/mL and the area under the curve was 0.72 (95%CI = 0.64–0.80, P = 0.0065). Spearman’s rank correlation analysis demonstrated that the concentrations of circulating HSP27 were positively associated with carotid IMT (r = 0.198, P = 0.007) and blood urea nitrogen (r = 0.170, P < 0.05). Furthermore, in the logistic model, serum HSP27 levels were found to be independent predictors for carotid IMT in type 2 diabetic patients after adjustment for onset age of diabetes, blood pressure, total cholesterol and C-reactive protein (OR = 1.085, P = 0.022).ConclusionsCirculating HSP27, positively correlates with carotid IMT, is an independent predictor for early atherosclerotic changes in diabetes, and may represent a novel marker of subclinical atherosclerosis in type 2 diabetes.
Highlights
Heat shock protein 27 (HSP27) has been proposed as a vital protective factor in atherosclerosis
We examined the association between circulating HSP27 levels and carotid intima–media thickness (IMT) in patients with type 2 diabetes to determine whether HSP27 may represent a potential predictor for early-stage atherosclerosis in this patient population
There were no statistical differences in sex, smoking status, alcohol consumption, use of lipid-lowering drugs, history of cardiovascular disease (CVD), duration of type 2 diabetes, Body mass index (BMI), Waist circumference (WC), waist–hip ratio (WHR), Fasting blood glucose (FBG), postprandial blood glucose (PBG), fasting insulin, fasting C peptide, 2 h insulin, 2 h C peptide, homeostasis model assessment of insulin resistance (HOMA-IR), hemoglobin A1c (HbA1c), blood urea nitrogen (BUN), serum creatinine (Scr), serum uric acid, estimated glomerular filtration rate (eGFR), TG, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) between the two groups
Summary
Heat shock protein 27 (HSP27) has been proposed as a vital protective factor in atherosclerosis. The objective of the present study was to evaluate the association between circulating HSP27 and carotid intima–media thickness (IMT) in individuals with type 2 diabetes and to determine whether HSP27 represents an independent marker of subclinical atherosclerosis in this patient population. Atherosclerotic cardiovascular disease (CVD) is the dominating cause of increasing mortality among patients with type 2 diabetes. Increasing carotid intima–media thickness (IMT), closely associated with CVD, is generally accepted as a surrogate marker of atherosclerosis [1,2,3]. Clinical studies have reported that serum HSP27 levels were dramatically decreased in patients with carotid atherosclerosis compared with healthy controls [8]. Low circulating HSP27 levels were found to be associated with high risk of coronary artery disease [9]. Reduced HSP27 levels were observed in unstable plaques versus stable plaques [10]
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