Abstract
BackgroundDetection of early vascular changes prior to clinical manifestations of atherosclerosis, such as increased arterial carotid intima-media thickness (CIMT) and impaired endothelial function is of paramount importance for early identification of subjects at increased risk of accelerated atherosclerosis. The present study was designed to evaluate the relationship between early atherosclerosis and endothelial dysfunction in type 1 diabetic patients based on measurements of CIMT and soluble CD146 (sCD146) levels.MethodsThirty-seven patients with type 1 diabetes, 14 males (37.8%) and 23 females (62.2%), of mean (SD) age 26.2 (4.1) years admitted to the outpatient diabetes clinic at Okmeydani Training and Research Hospital, Istanbul, between January 2008 and December 2012, and 37 healthy controls, 16 males (43.2%) and 21 females (56.8%), of mean (SD) age 25.8 (3.1) years, selected from relatives of patients, were included. Anthropometric measures; fasting plasma glucose; and serum HbA1c, total cholesterol, HDL-cholesterol, LDL-cholesterol, triglyceride and creatinine concentrations were compared, as were CIMT and serum sCD146.ResultsMean (SD) sCD146 levels were significantly higher in patients than in controls (314.6 (141.9) ng/ml vs. 207.8 (34.5) ng/ml, p = 0.001), but mean (SD) CIMT did not differ (0.5 (0.1) mm vs. 0.4 (0.1) mm). ROC curves for sCD146 significantly differed in differentiating type 1 diabetics from healthy controls (p = 0.0047) with a significantly higher percentage of patients than controls having sCD146 levels >260 ng/ml (21/37 (56.8%) vs. 2/37 (5.4%), p = 0.00011).ConclusionOur findings emphasize that sCD146 levels may be a more sensitive marker than CIMT for earlier identification of type 1 diabetic patients at high risk for atherosclerosis.
Highlights
Atherosclerosis is an important macrovascular complication and the major cause of morbidity and mortality in patients with diabetes mellitus [1]
SCD146 and carotid intima-media thickness (CIMT) values Mean (SD) soluble CD146 (sCD146) levels were significantly higher in patients with type 1 diabetes than in control subjects (314.6 (141.9) ng/ml vs. 207.8 (34.5) ng/ml, p = 0.001)
Receiver operating characteristic (ROC) curves for sCD146 and CMIT to differentiate type 1 diabetes mellitus from healthy controls ROC analysis showed that an sCD146 level of >260.74 ng/ml was the optimum cutoff for differentiating individuals with type 1 diabetes mellitus and healthy controls, with a sensitivity of 56.8%, a specificity of 94.6% and an likelihood ratio (LR) of 10.5%
Summary
Atherosclerosis is an important macrovascular complication and the major cause of morbidity and mortality in patients with diabetes mellitus [1]. Type 1 diabetes has been associated with increased intima media thickness and decreased endothelial function even in childhood [6], emphasizing the importance of early detection and prevention of macrovascular disease in patients with juvenile-onset type 1 diabetes. Detection of early vascular changes prior to clinical manifestations of atherosclerosis, such as increased arterial carotid intima-media thickness (CIMT) and impaired endothelial function is of paramount importance for early identification of subjects at increased risk of accelerated atherosclerosis. The present study was designed to evaluate the relationship between early atherosclerosis and endothelial dysfunction in type 1 diabetic patients based on measurements of CIMT and soluble CD146 (sCD146) levels
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