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Higher plasma levels linked to CV complications in type 1 diabetes

Issue: October 2014

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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.”

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.