Risk factors related to inflammation and endothelial dysfunction in the dcct/edic cohort and their relationship with nephropathy and macrovascular complications

Academic Article

Abstract

  • OBJECTIVE -Because endothelial cell dysfunction and inflammation are key contributors to the development of complications in type 1 diabetes, we studied risk factors related to endothelial dysfunction and inflammation (C-reactive protein and fibrinogen, soluble vascular cell adhesion molecule-1, intracellular adhesion molecule-1, and E-selectin, and fibrinolytic markers) in a subgroup of patients from the Diabetes Control and Complications Trial (DCCT)/ Epidemiology of Diabetes Intervention and Complications (EDIC) study cohort. RESEARCH DESIGN AND METHODS- We determined which of these risk factors or clusters thereof are associated with the presence of and subsequent development of nephropathy and macrovascular complications (reflected by carotid intima-media thickness [IMT]). RESULTS- After adjustment for conventional risk factors (age, sex, DCCT treatment group, diabetes duration, A1C, systolic blood pressure, waist-to-hip ratio, total and HDL cholesterol, and smoking status), fibrinogen remained strongly associated with progression of internal and common carotid IMT (P < 0.01) and soluble E-selectin had a strong association with nephropathy (P < 0.01). CONCLUSIONS - The best predictor for IMT progression in the DCCT/EDIC cohort was plasma fibrinogen, and the levels of soluble E-selectin discriminate patients with albuminuria better than conventional risk factors. © 2008 by the American Diabetes Association.
  • Published In

  • Diabetes Care  Journal
  • Digital Object Identifier (doi)

    Author List

  • Maria FLV; Carter RE; Gilbert GE; Klein RL; Jaffa M; Jenkins AJ; Lyons TJ; Garvey WT; Virella G
  • Start Page

  • 2006
  • End Page

  • 2012
  • Volume

  • 31
  • Issue

  • 10