J C Pickup1, M B Mattock. 1. Metabolic Unit, Guy's, King's and St Thomas's School of Medicine, Guy's Hospital, London, UK. john.pickup@kcl.ac.uk
Abstract
AIMS: Activation of innate immunity may play a major role in the development and pathophysiology of Type 2 diabetes; we therefore investigated whether a marker of innate immunity (serum sialic acid) predicts cardiovascular disease (CVD) and all-cause mortality in Type 2 diabetes. METHODS: Type 2 diabetic subjects (n=128, age 31-64 years at outset) participating in the Lewisham Diabetes Survey were followed up for a mean of 12.8 years. Baseline measurements were made of serum sialic acid and known or putative risk factors for CVD. Cause of death was coded from death certificates, post mortem examination and hospital records. RESULTS: Fifty-six (43%) subjects had died after 12.8 years. The major cause of death was CVD (71.4%), predominantly coronary heart disease (62.5%). Baseline variables significantly associated with CVD mortality were sialic acid and CVD (borderline significance smoking and cholesterol). In multivariate analysis, significant independent predictors of CVD mortality were sialic acid [standardized relative risk (95% confidence interval) 1.53 (1.12, 2.10)], age, male sex and existing CVD. CONCLUSIONS: Activated innate immunity (low-grade inflammation) is a risk factor for CVD mortality in Type 2 diabetes, independently of other known risk factors, including existing CVD. Since activation of the innate immune system predicts Type 2 diabetes, it may be a common antecedent of both Type 2 diabetes and CVD.
AIMS: Activation of innate immunity may play a major role in the development and pathophysiology of Type 2 diabetes; we therefore investigated whether a marker of innate immunity (serum sialic acid) predicts cardiovascular disease (CVD) and all-cause mortality in Type 2 diabetes. METHODS: Type 2 diabetic subjects (n=128, age 31-64 years at outset) participating in the Lewisham Diabetes Survey were followed up for a mean of 12.8 years. Baseline measurements were made of serum sialic acid and known or putative risk factors for CVD. Cause of death was coded from death certificates, post mortem examination and hospital records. RESULTS: Fifty-six (43%) subjects had died after 12.8 years. The major cause of death was CVD (71.4%), predominantly coronary heart disease (62.5%). Baseline variables significantly associated with CVD mortality were sialic acid and CVD (borderline significance smoking and cholesterol). In multivariate analysis, significant independent predictors of CVD mortality were sialic acid [standardized relative risk (95% confidence interval) 1.53 (1.12, 2.10)], age, male sex and existing CVD. CONCLUSIONS: Activated innate immunity (low-grade inflammation) is a risk factor for CVD mortality in Type 2 diabetes, independently of other known risk factors, including existing CVD. Since activation of the innate immune system predicts Type 2 diabetes, it may be a common antecedent of both Type 2 diabetes and CVD.
Authors: Daniela Pedicino; Giovanna Liuzzo; Francesco Trotta; Ada Francesca Giglio; Simona Giubilato; Francesca Martini; Francesco Zaccardi; Giuseppe Scavone; Marco Previtero; Gianluca Massaro; Pio Cialdella; Maria Teresa Cardillo; Dario Pitocco; Giovanni Ghirlanda; Filippo Crea Journal: J Diabetes Res Date: 2013-05-23 Impact factor: 4.011
Authors: Khalida Ismail; Calum D Moulton; Kirsty Winkley; John C Pickup; Stephen M Thomas; Roy A Sherwood; Daniel Stahl; Stephanie A Amiel Journal: Diabetologia Date: 2017-08-03 Impact factor: 10.122