Key result
Concurrent diabetes and cardiovascular disease was associated with significantly higher levels of VEGF, von Willebrand factor, and endothelial microparticles compared to either condition alone.
Why the study?
The study evaluated whether metabolic, endothelial, renal, angiogenic, and platelet abnormalities are more adverse in patients with cardiovascular disease compounded by diabetes compared to either condition alone.
Cross-Sectional (n=212)
No
Absolute Event Rate: 123% vs 109%
p-value: p=0.001
Patients with both diabetes and cardiovascular disease exhibit a more adverse endothelial and angiogenic biomarker profile than those with either condition alone.
Indicates additive endothelial dysregulation in comorbid diabetes-CVD; leaves open whether biomarkers improve risk stratification or therapy.
Introduction: Diabetes is a leading risk factor for cardiovascular disease (CVD), the pathophysiology of both being linked to metabolic, endothelial, renal, angiogenic and platelet abnormalities. We hypothesised that abnormalities in these systems are more adverse in those whose CVD is compounded by diabetes, compared to those with diabetes or CVD alone. Materials and methods: Serum or plasma from 66 patients with diabetes alone, 76 with CVD alone, and 70 with both diabetes and CVD i.e. diabetic cardiovascular disease, was probed for markers of angiogenesis [angiopoietin 1 and 2, vascular endothelial growth factor (VEGF) and endoglin], metabolic [soluble receptor for advanced glycation products (sRAGE), leptin, lipocalin-2, interleukin-8, and cystatin-C], the endothelium (von Willebrand factor, endothelial microparticles and soluble E selectin)], and the platelet (platelet microparticles and soluble P selectin) by ELISA, Luminex or flow cytometry. Results: VEGF ( p = 0.04), von Willebrand factor ( p = 0.001) and endothelial microparticles ( p = 0.042) were all higher in diabetic cardiovascular disease than in diabetes alone and cardiovascular disease alone. Soluble E selectin was higher in diabetic cardiovascular disease than in diabetes alone ( p = 0.045), whilst cystatin-C ( p = 0.004) and soluble P selectin ( p < 0.001) were higher in diabetes and diabetic cardiovascular disease than in cardiovascular disease alone. There were no differences in angiopoietin 1 or 2, endoglin, sRAGE, leptin, lipocalin-2, or interleukin-8. Conclusion: Angiopoietin 1 or 2, endoglin, sRAGE, leptin, lipocalin-2, interleukin-8, and cystatin-c cannot differentiate diabetes from cardiovascular disease, or both conditions combined. Our data point to a more adverse endothelial (von Willebrand factor, endothelial microparticles), and angiogenic profile (VEGF) in those with diabetic cardiovascular disease, supporting the view that this group should be targeted more aggressively.
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Blann et al. (2022) conducted a cross-sectional in Diabetes and Cardiovascular Disease (n=212). Concurrent diabetes and cardiovascular disease vs. Diabetes alone or cardiovascular disease alone was evaluated on von Willebrand factor (vWf) levels (IU/dl) (p=0.001). Concurrent diabetes and cardiovascular disease was associated with significantly higher levels of VEGF, von Willebrand factor, and endothelial microparticles compared to either condition alone.
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