OBJECTIVE: Tumor necrosis factor-alpha (TNF-alpha), a cytokine secreted by adipose tissue and other cells, might play a role in insulin resistance. RESEARCH DESIGN AND METHODS: Of 32,826 women from the Nurses' Health Study who provided blood at baseline, we followed 929 women with type 2 diabetes. During 10 years of follow-up, we documented 124 incident cases of coronary heart disease (CHD). RESULTS: After adjustment for age, smoking, BMI, and other cardiovascular risk factors, the relative risks (RRs) comparing extreme quartiles of soluble TNF-alpha receptor II (sTNF-RII) were 2.48 (95% CI 1.08-5.69; P = 0.034) for myocardial infarction (MI) and 2.02 (1.17-3.48; P = 0.003) for total CHD. The probability of developing CHD over 10 years was higher among diabetic subjects with substantially higher levels of both sTNF-RII (>75th percentile) and HbA(1c) (>7%), compared with diabetic subjects with lower levels (25% vs. 7%, P < 0.0001). Diabetic subjects with only higher sTNF-RII or HbA(1c) had similar (16-17%) risk. In a multivariate model, diabetic subjects with higher levels of both sTNF-RII and HbA(1c) had an RR of 3.66 (1.85-7.22) for MI and 3.03 (1.82-5.05) for total CHD, compared with those with lower levels of both biomarkers. CONCLUSIONS: Increased levels of sTNF-RII were strongly associated with risk of CHD among diabetic women, independent of hyperglycemia.
OBJECTIVE:Tumor necrosis factor-alpha (TNF-alpha), a cytokine secreted by adipose tissue and other cells, might play a role in insulin resistance. RESEARCH DESIGN AND METHODS: Of 32,826 women from the Nurses' Health Study who provided blood at baseline, we followed 929 women with type 2 diabetes. During 10 years of follow-up, we documented 124 incident cases of coronary heart disease (CHD). RESULTS: After adjustment for age, smoking, BMI, and other cardiovascular risk factors, the relative risks (RRs) comparing extreme quartiles of soluble TNF-alpha receptor II (sTNF-RII) were 2.48 (95% CI 1.08-5.69; P = 0.034) for myocardial infarction (MI) and 2.02 (1.17-3.48; P = 0.003) for total CHD. The probability of developing CHD over 10 years was higher among diabetic subjects with substantially higher levels of both sTNF-RII (>75th percentile) and HbA(1c) (>7%), compared with diabetic subjects with lower levels (25% vs. 7%, P < 0.0001). Diabetic subjects with only higher sTNF-RII or HbA(1c) had similar (16-17%) risk. In a multivariate model, diabetic subjects with higher levels of both sTNF-RII and HbA(1c) had an RR of 3.66 (1.85-7.22) for MI and 3.03 (1.82-5.05) for total CHD, compared with those with lower levels of both biomarkers. CONCLUSIONS: Increased levels of sTNF-RII were strongly associated with risk of CHD among diabeticwomen, independent of hyperglycemia.
Authors: Luca Miele; Giovanni Gasbarrini; Valentina Giorgio; Antonio Gasbarrini; Antonio Grieco Journal: Intern Emerg Med Date: 2015-11-24 Impact factor: 3.397
Authors: Monika A Niewczas; Tomohito Gohda; Jan Skupien; Adam M Smiles; William H Walker; Florencia Rosetti; Xavier Cullere; John H Eckfeldt; Alessandro Doria; Tanya N Mayadas; James H Warram; Andrzej S Krolewski Journal: J Am Soc Nephrol Date: 2012-01-19 Impact factor: 10.121
Authors: Barbara J Jefferis; Peter H Whincup; Paul Welsh; S Goya Wannamethee; Ann Rumley; Lucy T Lennon; Andrew G Thomson; Claire Carson; Shah Ebrahim; Gordon D O Lowe Journal: Atherosclerosis Date: 2008-12-06 Impact factor: 5.162