Antibodies to oxidized LDL predict coronary artery disease in type 1 diabetes: a nested case-control study from the Pittsburgh Epidemiology of Diabetes Complications Study.
The pathogenesis of excess cardiovascular risk in type 1 diabetes is unclear. LDL cholesterol is only weakly predictive, and its concentration is often normal in type 1 diabetes. We therefore examined whether markers of LDL oxidation such as antibodies to oxidized LDL (Ab-OxLDL) and LDL-containing immune complexes, rather than LDL concentration, were predictive of coronary artery disease (CAD) in type 1 diabetes. This nested case-control study from an epidemiologic cohort study included 49 incident cases of myocardial infarction (MI), angina, or CAD death and 49 age-, sex-, and duration-matched control subjects. Ab-OxLDL was measured by enzyme immunoassay and the apolipoprotein B (ApoB) content of immune complexes (ApoB-IC) precipitated by polyethylene glycol by immunoelectrophoresis in baseline stored samples. Ab-OxLDL was inversely, and ApoB-IC directly, related to subsequent CAD. In multivariate analyses, Ab-OxLDL remained a significant independent predictor along with previously recognized predictors, hypertension and Beck depression score. In conclusion, oxidation of LDL and the immune response it elicits may play a role in predicting the development of CAD in type 1 diabetes and explain at least some of the enhanced CAD risk in type I diabetes.
Orchard
T J
TJ
Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania, USA.
Virella
G
G
Forrest
K Y
KY
Evans
R W
RW
Becker
D J
DJ
Lopes-Virella
M F
MF
D000328:Adult; D017668:Age of Onset; D016022:Case-Control Studies; D002648:Child; D003327:Coronary Disease / Q000276:immunology*; D003922:Diabetes Mellitus, Type 1 / Q000276:immunology*; D003925:Diabetic Angiopathies / Q000453:epidemiology / Q000276:immunology*; D005500:Follow-Up Studies; D006031:Glycosylation; D006801:Humans; D008077:Lipoproteins, LDL / Q000276:immunology*; D015999:Multivariate Analysis; D010084:Oxidation-Reduction; D010414:Pennsylvania / Q000453:epidemiology; D012307:Risk Factors
D008077:Lipoproteins, LDL