Coronary artery calcification, arterial stiffness and renal insufficiency associate with serum levels of tumor necrosis factor-alpha in Japanese type 2 diabetic patients.
Although the kidneys are the major source of proinflammatory cytokines, association of tumor necrosis factor-alpha (TNF-alpha) with severity of atherosclerosis or kidney function in diabetic patients is unclear. Two hundred type 2 diabetic patients and 30 age-matched nondiabetic subjects consecutively admitted to our hospital were enrolled. The Agatston coronary artery calcium score (CACS), a quantitative marker of coronary atherosclerosis, was obtained using multidetector-row computed tomography. Arterial stiffness was assessed by brachial-ankle pulse wave velocity (baPWV). Diabetic patients had higher log(CACS+1) (p=0.0089), baPWV (p=0.0293), frequency of elevated urinary albumin excretion (UAE) (p<0.0001) and TNF-alpha (p=0.0029) and similar estimated glomerular filtration rate (eGFR) compared to nondiabetic subjects. When diabetic patients were grouped into four subgroups with or without elevated UAE and renal insufficiency (UAE of >/=30 or <30mg/24h and eGFR of <60 or >/=60ml/min per 1.73m(2)), patients with micro- and macroalbuminuric renal insufficiency showed the highest log(CACS+1) (p<0.0001), baPWV (p=0.0068) and TNF-alpha (p<0.0001) of these groups. Log(CACS+1) (p=0.0008) and baPWV (p=0.0006) positively and eGFR (p<0.0001) negatively correlated with TNF-alpha in diabetic patients. We find that coronary artery calcification, arterial stiffness, and renal insufficiency associate with circulating levels of TNF-alpha in type 2 diabetic patients.
Department of Diabetes and Endocrinology, Gifu University School of Medicine, 1-1 Yanagido, Gifu, Gifu 501-1194, Japan.
Takuo
T
Hirota
Eiji
E
Suzuki
Isamu
I
Ito
Masami
M
Ishiyama
Shinobu
S
Goto
Yukio
Y
Horikawa
Takahiko
T
Asano
Masayuki
M
Kanematsu
Hiroaki
H
Hoshi
Jun
J
Takeda
D044466:Asian People; D002114:Calcinosis / Q000097:blood* / Q000473:pathology; D003324:Coronary Artery Disease / Q000097:blood / Q000473:pathology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000208:ethnology / Q000473:pathology; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D051437:Renal Insufficiency / Q000097:blood* / Q000473:pathology; D014057:Tomography, X-Ray Computed; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*
D014409:Tumor Necrosis Factor-alpha