Higher plasma levels linked to CV complications in type 1 diabetes
Cardiovascular complications are associated with higher plasma levels in patients with type 1 diabetes, according to a presenter at the 50th European Association for the Study of Diabetes Annual Meeting.
“Cardiovascular mortality is the leading cause of death in type 1 diabetic patients,” Stijn A. Peeters, MD, a PhD student in the CARIM School for Cardiovascular Diseases at Maastricht University, the Netherlands, said during his presentation. “We think extracellular matrix remodeling could contribute to this complication.”
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Stijn A. Peeters
To investigate that hypothesis, Peeters and colleagues looked at multiple matrix metalloproteinases (MMPs) and tissue inhibitor of metalloproteinase (TIMP) in a cohort of patients with type 1 diabetes (n=493; median age, 39.5 years; 51% male) from the EURODIAB Prospective Complications Study. Specifically, they measured the associations between MMP-1, -2, -3, -9 and -10, and TIMP-1 in cardiovascular disease, as well as microvascular complications.
Patients with CVD (n=118) had significantly higher levels of TIMP-1 (beta=0.32; 95% CI,
0.12-0.52) than those without CVD (n=375). Higher plasma levels of MMP-2, -3, -10 and TIMP-1 were associated with increasing levels of albuminuria.
“This has been observed in the literature previously, but not in type 1 diabetes patients,” Peeters said.
Proliferative retinopathy was associated with higher levels of MMP-2 (P=.017). All were largely independent of low-grade inflammation and/or endothelial dysfunction, Peeters said.
“We can only speculate on causality. … TIMP-1 was associated with prior CVD, which has also been observed in two studies with type 2 diabetes patients. We don’t know whether plasma levels really reflect tissue levels,” he said. “Further prospective studies are needed to clarify the role of these MMPs and TIMP-1 in the development of cardiovascular disease in diabetes.”
For more information:
Peeters SA. Abstract #93. Presented at: 50th EASD Annual Meeting; Sept. 16-19, 2014; Vienna.
Disclosure: Peeters reported no relevant financial relationships.