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

F. Lopes Virella Maria, Rickey E. Carter, Gregory E. Gilbert, Richard L. Klein, Miran Jaffa, Alicia J. Jenkins, Timothy J. Lyons, W. Timothy Garvey, Gabriel Virella

Research output: Contribution to journalArticle

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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.

Original languageEnglish (US)
Pages (from-to)2006-2012
Number of pages7
JournalDiabetes Care
Volume31
Issue number10
DOIs
StatePublished - Oct 2008
Externally publishedYes

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Diabetes Complications
E-Selectin
Inflammation
Fibrinogen
Carotid Intima-Media Thickness
Epidemiology
Blood Pressure
Albuminuria
Waist-Hip Ratio
Vascular Cell Adhesion Molecule-1
Type 1 Diabetes Mellitus
C-Reactive Protein
HDL Cholesterol
Cohort Studies
Research Design
Endothelial Cells
Smoking

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

Cite this

Risk factors related to inflammation and endothelial dysfunction in the dcct/edic cohort and their relationship with nephropathy and macrovascular complications. / Maria, F. Lopes Virella; Carter, Rickey E.; Gilbert, Gregory E.; Klein, Richard L.; Jaffa, Miran; Jenkins, Alicia J.; Lyons, Timothy J.; Garvey, W. Timothy; Virella, Gabriel.

In: Diabetes Care, Vol. 31, No. 10, 10.2008, p. 2006-2012.

Research output: Contribution to journalArticle

Maria, F. Lopes Virella ; Carter, Rickey E. ; Gilbert, Gregory E. ; Klein, Richard L. ; Jaffa, Miran ; Jenkins, Alicia J. ; Lyons, Timothy J. ; Garvey, W. Timothy ; Virella, Gabriel. / Risk factors related to inflammation and endothelial dysfunction in the dcct/edic cohort and their relationship with nephropathy and macrovascular complications. In: Diabetes Care. 2008 ; Vol. 31, No. 10. pp. 2006-2012.
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AU - Maria, F. Lopes Virella

AU - Carter, Rickey E.

AU - Gilbert, Gregory E.

AU - Klein, Richard L.

AU - Jaffa, Miran

AU - Jenkins, Alicia J.

AU - Lyons, Timothy J.

AU - Garvey, W. Timothy

AU - Virella, Gabriel

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AB - 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.

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