An update on markers of carotid atherosclerosis in patients with Type 2 diabetes

Department of Vascular Surgery, Attikon University Hospital, Medical School, Athens, Greece.
Biomarkers in Medicine (Impact Factor: 2.65). 08/2010; 4(4):601-9. DOI: 10.2217/bmm.10.79
Source: PubMed


Carotid atherosclerosis constitutes an important cause of ischemic brain attack and stroke, accounting for up to 40% of cases of ischemic cerebrovascular disease. Type 2 diabetes mellitus is an independent risk factor for stroke and its recurrence. Thus, identifying diabetic patients who are at high risk of developing stroke is of great clinical importance. Noninvasive measurements of surrogate markers of atherosclerosis, such as novel serum biomarkers, can be helpful in detecting subclinical carotid disease, especially among individuals at the highest cardio-/cerebro-vascular risk. Previous studies have proposed an expanding body of serum biomarkers, such as C-reactive protein, fibrinogen, adipokines, cytokines and growth factors, as novel indicators of carotid atherosclerosis development that predict carotid-related clinical outcomes. Furthermore, those biomarkers are expected to assess the efficacy of both pharmaceutical and interventional strategies. Accordingly, it is increasingly clear that measuring biomarkers may improve the definition of cerebrovascular risk profile in patients with Type 2 diabetes mellitus.

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    • "Prior studies have proposed that measuring biomarkers of atherosclerosis can be helpful in detecting macrovascular complications of diabetes, such as subclinical carotid disease [11]. "
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    ABSTRACT: The guest editors wish to thank all the authors who submitted their work for consideration for this special issue and the reviewers who evaluated the papers. Without their efforts and valuable contribution, this special issue would not have been published.
    Journal of Diabetes Research 08/2015; 2015(5):189525. DOI:10.1155/2015/189525 · 2.16 Impact Factor
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    • "Potential applications of these observations have implications in clinical management of T2D patients with PAD. Previous studies imply that measuring inflammatory biomarkers may improve the definition of cerebrovascular risk profile in patients with type 2 diabetes [31]. Improvement of inflammatory state in diabetic population is associated with improvement of glyco-metabolic control. "
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    ABSTRACT: Background Limited studies have suggested that inflammatory biomarkers play a role in the initiation and progression of atherosclerosis in diabetic patients. This study assesses the effect of inflammatory biomarkers: fibrinogen and C-reactive protein (C-RP) on the progression of peripheral arterial disease (PAD) in type 2 diabetic (T2D) patients. Methods Sixty two patients with T2D and PAD (mean age 60.28 ± 27 years and diabetes duration of 8.58 ± 6.17 years) were enrolled in a cohort prospective study of 36 months. Ankle-brachial index (ABI) was measured in all patients at baseline and after 36 months. Multiple linear regression analysis was used to determine the predictivity of variables for fibrinogen, C-RP, plasma lipid fractions, fasting plasma glucose, Body Mass Index (BMI), duration of diabetes status and the age on changes in ABI value. Results Linear regression analysis defined F as a predictor for endpoint value of ABI (β = 0.469, p = 0.007). Value of C-RP determinates change of minimal value of ABI (β = 0.449, p = 0.037) and change of mean ABI per year (β = 0.442, p = 0.025). Conclusion Our data indicate that plasma determination of fibrinogen and C-RP might have a clinical implication in defining the process of progression of PAD in T2D population.
    Cardiovascular Diabetology 02/2013; 12(1):29. DOI:10.1186/1475-2840-12-29 · 4.02 Impact Factor
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    • "A growing body of evidence supports the predominant role of chronic, low-grade inflammation in mediating insulin resistance and all stages of atherosclerosis in type 2 diabetes mellitus (T2DM) [1]. Among pro-inflammatory mediators associated with cardiovascular diseases (CVD), adipose-tissue derived cytokines, known as adipokines, have emerged as potential key factors of atherosclerosis-related complications [2]. "
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    ABSTRACT: Accumulating data support the atheroprotective role of the novel adipokines, apelin and ghrelin. The aim of the present randomized study was to investigate the effects of aerobic exercise training on these adipokines in patients with type 2 diabetes mellitus (T2DM). Fifty-four overweight (BMI >25 kg/m²) patients with T2DM, but without vascular complications, were randomized to either the aerobic exercise training group (EG, N=27), 4 times/week, 45-60 min/session; or to the control group (CG, N=27), orally instructed to increase physical activity. Clinical glycemic and lipid parameters, exercise capacity (VO₂peak), insulin, HOMA-IR, and serum levels of apelin and ghrelin were assessed at baseline and after 12 weeks. Aerobic exercise significantly improved lipid and glycemic profile and insulin sensitivity compared to CG (p<0.05). Furthermore, between-groups comparison showed a considerable exercise-induced upregulation in apelin (p=0.007) and VO₂peak (p<0.001) levels. Negligible changes in body-weight, waist-hip ratio and ghrelin concentrations were detected within and between groups after the completion of the study (p>0.05). However, subgroup analysis revealed a considerable increment in ghrelin levels only in the exercise-treated women compared to their control counterparts (p=0.038). LDL and HOMA-IR reduction were found to be independent predictors of apelin increment in multiple regression analysis (R²=0.391, p=0.011). In patients with T2DM, systemic, long-term, aerobic exercise exerts positive effects on apelin and ghrelin (only in women), even in the absence of significant weight loss, suggesting its pleiotropic effects.
    Medical science monitor: international medical journal of experimental and clinical research 04/2012; 18(5):CR290-5. DOI:10.12659/MSM.882734 · 1.43 Impact Factor
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