Relationship between plasma sialic acid and fibrinogen concentration and incident micro- and macrovascular complications in type 1 diabetes. The Eurodiab Prospective Complications Study(PCS)

Autor: SOEDAMAH MUTHU SS, Chaturvedi, N, Pickup, Jc, Fuller, Jh, On behalf of EURODIAB PCS STUDY GROUP, Miccoli, Roberto
Jazyk: angličtina
Rok vydání: 2008
Předmět:
Male
Complications
type 1 diabetes
Endocrinology
Diabetes and Metabolism
030204 cardiovascular system & hematology
Fibrinogen
Gastroenterology
chemistry.chemical_compound
0302 clinical medicine
Medicine
plasma sialic acid
Diabetic retinopathy
Middle Aged
3. Good health
Coronary heart disease
Europe
Type 1 diabetes
Female
medicine.symptom
medicine.drug
Adult
medicine.medical_specialty
Adolescent
030209 endocrinology & metabolism
Diabetic angiopathy
Article
Geneeskunde
03 medical and health sciences
Internal medicine
Diabetes mellitus
Internal Medicine
Albuminuria
Humans
Analysis of Variance
Diabetic Retinopathy
business.industry
medicine.disease
Sialic acid
N-Acetylneuraminic Acid
Macrovascular
Endocrinology
CHD
Diabetes Mellitus
Type 1
chemistry
Multivariate Analysis
Microvascular
business
N-Acetylneuraminic acid
Diabetic Angiopathies
Zdroj: Diabetologia
Popis: Aims/hypothesis Type 1 diabetes is associated with an increased risk of vascular complications. This increased risk could be explained by sialic acid and/or fibrinogen. It is also not clear what explains the abolition of sex-related differences affecting risk of CHD in the presence of type 1 diabetes. Therefore, we examined whether fibrinogen and sialic acid are related to incident micro- and macrovascular complications in patients with type 1 diabetes. Methods A subset (n = 2329) of the EURODIAB Prospective Complications Study was analysed. Sialic acid and fibrinogen concentrations were measured at baseline. The main outcomes after 7 years were development of albuminuria, retinopathy, neuropathy and CHD. Results Univariable and multivariable models using Cox proportional survival analyses showed that an SD unit increase in sialic acid and fibrinogen levels was significantly associated with CHD in men only. Adjusted standardised hazard ratios (sHRs) were 1.50 (95% CI 1.05–2.15) and 1.40 (95% CI 1.06–1.86) for sialic acid and fibrinogen, respectively. Initial associations between (1) sialic acid and incident retinopathy [standardised odds ratio (sOR) men 1.68, 95% CI 1.10–2.57], (2) fibrinogen and retinopathy (sOR women 1.37, 95% CI 1.06–1.78) and (3) sialic acid and neuropathy (sOR men 1.37, 95% CI 1.06–1.77) were shown, but became non-significant in multivariable models. Conclusions/interpretation Sialic acid and fibrinogen are strong predictors of CHD in men with type 1 diabetes, beyond the effect of established risk factors. The associations found with microvascular complications were not independent of other risk factors. Electronic supplementary material The online version of this article (doi:10.1007/s00125-007-0905-8) contains supplementary material and details of all EURODIAB Prospective Complications Study investigators and staff, and is available to authorised users.
Databáze: OpenAIRE
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