Association between renin and atherosclerotic burden in subjects with and without type 2 diabetes

Autor: Gerd Östling, Andreas Edsfeldt, Gunilla Nordin Fredrikson, S. Pinnola, Andrea Natali, Phil Gates, Angela C. Shore, Michaela Kozakova, Elena Venturi, Jan Nilsson, Volker Schnecke, Helen M. Colhoun, Eva Bengtsson, Li Ming Gan, Margaretha Persson, Carlo Palombo, Fiona Adams, Helen C. Looker, Kunihiko Aizawa, Maria Wigren, Isabel Gonçalves, Kim M. Gooding, Jill J. F. Belch, Francesco Casanova, Harry Björkbacka, Faisel Khan
Rok vydání: 2016
Předmět:
Carotid Artery Diseases
Male
endocrine system diseases
medicine.medical_treatment
Carotid endarterectomy
Type 2 diabetes
030204 cardiovascular system & hematology
Carotid Intima-Media Thickness
Plasma renin activity
0302 clinical medicine
Risk Factors
Renin
Endothelial dysfunction
030212 general & internal medicine
Pulse wave velocity
Endarterectomy
2. Zero hunger
Prognosis
Arterial stiffness
Plaque
Atherosclerotic
3. Good health
Carotid Arteries
cardiovascular system
Cardiology
Female
Cardiology and Cardiovascular Medicine
Research Article
medicine.medical_specialty
03 medical and health sciences
Vascular Stiffness
Diabetes mellitus
Internal medicine
medicine
Humans
Ankle Brachial Index
Aged
Retrospective Studies
Angiology
business.industry
nutritional and metabolic diseases
Atherosclerosis
medicine.disease
Diabetes Mellitus
Type 2
Endothelium
Vascular
business
Biomarkers
Follow-Up Studies
Zdroj: BMC Cardiovascular Disorders
ISSN: 1471-2261
DOI: 10.1186/s12872-016-0346-8
Popis: Background Activation of the renin-angiotensin-aldosterone-system (RAAS) has been proposed to contribute to development of vascular complications in type 2 diabetes (T2D). The aim of the present study was to determine if plasma renin levels are associated with the severity of vascular changes in subjects with and without T2D. Methods Renin was analyzed by the Proximity Extension Assay in subjects with (n = 985) and without (n = 515) T2D participating in the SUMMIT (SUrrogate markers for Micro- and Macro-vascular hard endpoints for Innovative diabetes Tools) study and in 205 carotid endarterectomy patients. Vascular changes were assessed by determining ankle-brachial pressure index (ABPI), carotid intima-media thickness (IMT), carotid plaque area, pulse wave velocity (PWV) and the reactivity hyperemia index (RHI). Results Plasma renin was elevated in subjects with T2D and demonstrated risk factor-independent association with prevalent cardiovascular disease both in subjects with and without T2D. Renin levels increased with age, body mass index, HbA1c and correlated inversely with HDL. Subjects with T2D had more severe carotid disease, increased arterial stiffness, and impaired endothelial function. Risk factor-independent associations between renin and APBI, bulb IMT, carotid plaque area were observed in both T2D and non-T2D subjects. These associations were independent of treatment with RAAS inhibitors. Only weak associations existed between plasma renin and the expression of pro-inflammatory and fibrous components in plaques from 205 endarterectomy patients. Conclusions Our findings provide clinical evidence for associations between systemic RAAS activation and atherosclerotic burden and suggest that this association is of particular importance in T2D.
Databáze: OpenAIRE
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