Abstract
BackgroundNegative coronary artery remodeling is frequent in patients with diabetes, but its mechanism remains unclear. We here evaluated the association of serum levels of glycated albumin (GA) and endogenous secretory receptor for advanced glycation end products (esRAGE) with coronary artery remodeling in type 2 diabetic patients.MethodsSerum levels of GA and esRAGE were measured and intravascular ultrasound was performed in 136 consecutive diabetic patients with 143 coronary intermediate lesions. The remodeling index (RI) was calculated as the ratio between external elastic membrane (EEM) area at the lesion site and EEM area at the reference segment. Negative remodeling (NR) was defined as an RI < 0.95 and intermediate or positive remodeling as an RI ≥ 0.95.ResultsMean plaque burden at the lesion site was 70.96 ± 9.98%, and RI was 0.96 ± 0.18. Negative coronary arterial remodeling existed in 81 (56.6%) lesions. RI correlated closely with serum esRAGE level (r = 0.236, P = 0.005) and was inversely related to serum GA level (r = − 0.240, P = 0.004) and plasma low-density lipoprotein cholesterol (LDL-C) (r = − 0.206, P = 0.014) and total cholesterol levels (r = − 0.183, P = 0.028). Generalized estimating equations logistic regression analysis identified esRAGE (OR 0.037; 95% CI 0.012–0.564, P = 0.021), GA (OR 1.093; 95% CI 1.013–1.179, P = 0.018) and LDL-C (OR 1.479; 95% CI 1.072–2.835, P = 0.023) as independent predictors for negative remodeling.ConclusionsIn diabetic patients, negative coronary artery remodeling is associated with increased GA and decreased esRAGE levels in serum.
Highlights
Coronary arterial remodeling occurs frequently during the development and progression of atherosclerosis, and is associated with clinical presentations in patients with coronary artery disease [1]
Baseline characteristics A total of 136 diabetic patients with 143 lesions were enrolled in this study
Intravascular ultrasound (IVUS) findings There were no significant differences between Negative remodeling (NR) group and insulin resistance (IR)/PR group with regard to parameters of proximal and distal reference vessels
Summary
Coronary arterial remodeling (changes in vascular dimensions) occurs frequently during the development and progression of atherosclerosis, and is associated with clinical presentations in patients with coronary artery disease [1]. The exact mechanisms of negative coronary artery remodeling in diabetic patients remain not fully elucidated. Glycated albumin (GA), an Amadori-modified early glycation product, intensifies inflammatory reaction and is associated with coronary artery disease in patients with diabetes [16,17,18]. We sought to evaluate the association of increased GA and decreased esRAGE levels in serum with the incidence and degree of negative coronary artery remodeling in type 2 diabetic patients. Negative coronary artery remodeling is frequent in patients with diabetes, but its mechanism remains unclear. We here evaluated the association of serum levels of glycated albumin (GA) and endogenous secretory receptor for advanced glycation end products (esRAGE) with coronary artery remodeling in type 2 diabetic patients
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