title: Risk factors related to inflammation and endothelial dysfunction in the DCCT/EDIC cohort and their relationship with nephropathy and macrovascular complications.
abstract: OBJECTIVE
  Because endothelial cell dysfunction and inflammation are key contributors to the development of complications in type 1 diabetes, we studied risk factors related to endothelial dysfunction and inflammation (C-reactive protein and fibrinogen, soluble vascular cell adhesion molecule-1, intracellular adhesion molecule-1, and E-selectin, and fibrinolytic markers) in a subgroup of patients from the Diabetes Control and Complications Trial (DCCT)/Epidemiology of Diabetes Intervention and Complications (EDIC) study cohort.
  
  
  METHODS
  We determined which of these risk factors or clusters thereof are associated with the presence of and subsequent development of nephropathy and macrovascular complications (reflected by carotid intima-media thickness [IMT]).
  
  
  RESULTS
  After adjustment for conventional risk factors (age, sex, DCCT treatment group, diabetes duration, A1C, systolic blood pressure, waist-to-hip ratio, total and HDL cholesterol, and smoking status), fibrinogen remained strongly associated with progression of internal and common carotid IMT (P < 0.01) and soluble E-selectin had a strong association with nephropathy (P < 0.01).
  
  
  CONCLUSIONS
  The best predictor for IMT progression in the DCCT/EDIC cohort was plasma fibrinogen, and the levels of soluble E-selectin discriminate patients with albuminuria better than conventional risk factors.
authors.affiliation: Department of Medicine and Laboratory Services, Medical University of South Carolina and Ralph H Johnson VA Medical Center, Charleston, South Carolina, USA. virellam@musc.edu
authors.forename: Maria F
authors.initials: MF
authors.lastname: Lopes-Virella
authors.forename: Rickey E
authors.initials: RE
authors.lastname: Carter
authors.forename: Gregory E
authors.initials: GE
authors.lastname: Gilbert
authors.forename: Richard L
authors.initials: RL
authors.lastname: Klein
authors.forename: Miran
authors.initials: M
authors.lastname: Jaffa
authors.forename: Alicia J
authors.initials: AJ
authors.lastname: Jenkins
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Lyons
authors.forename: W Timothy
authors.initials: WT
authors.lastname: Garvey
authors.forename: Gabriel
authors.initials: G
authors.lastname: Virella
mesh_terms: D000328:Adult; D000419:Albuminuria / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D002339:Carotid Arteries / Q000473:pathology; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications / Q000503:physiopathology; D003925:Diabetic Angiopathies / Q000453:epidemiology* / Q000517:prevention & control; D003928:Diabetic Nephropathies / Q000453:epidemiology* / Q000517:prevention & control; D004730:Endothelium, Vascular / Q000473:pathology*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000453:epidemiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D012044:Regression Analysis; D012307:Risk Factors; D017539:Tunica Intima / Q000473:pathology; D017540:Tunica Media / Q000473:pathology
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein