title: Oxidized LDL immune complexes and coronary artery calcification in type 1 diabetes.
abstract: OBJECTIVE
  Oxidized LDL (oxLDL) and oxLDL antibodies form immune complexes (IC) that reflect essential components in the development of atherosclerosis: dyslipidemia, oxidative stress and induction of a pro-inflammatory humoral immune response. We measured oxLDL in IC (oxLDL-IC) isolated from patients with type 1 diabetes to assess the relationship between oxLDL-IC and coronary artery calcification (CAC).
  
  
  METHODS
  OxLDL was measured in IC isolated from baseline samples from a subgroup of 476 patients of the Diabetes Control and Complications Trial (DCCT). CAC was determined by computed tomography (CT) 11-20 years later. Multivariable log-binomial regression models were used to estimate the risk ratios associated with having a high CAC score with an increase of 1 standard deviation (SD) of the natural logarithm of oxLDL-IC.
  
  
  RESULTS
  Multivariable regression models indicate that a 1 SD increase in the levels of oxLDL-IC was associated with a 37% increase in the risk of having high CAC score (RR=1.36; 95% CI: 1.12-1.67) at follow-up after adjustment for DCCT treatment group, retinopathy/AER groups, gender and CT scanning site as well as baseline age, diabetes duration and HbA1C %. Further adjustment for smoking status, blood pressure and LDL resulted in a risk ratio of 1.23 (95% CI: 1.01-1.50) which remained statistically significant indicating that baseline oxLDL-IC is independently associated with the development of CAC.
  
  
  CONCLUSIONS
  Increased levels of oxLDL-IC are associated with the development of coronary calcification. This observation reinforces previously published clinical and experimental data demonstrating that oxLD-IC has pro-inflammatory and proatherogenic properties.
authors.affiliation: Department of Medicine, Medical University of South Carolina, Charleston, SC, United States. virellam@musc.edu
authors.forename: Maria F
authors.initials: MF
authors.lastname: Lopes-Virella
authors.forename: Nathaniel L
authors.initials: NL
authors.lastname: Baker
authors.forename: Kelly J
authors.initials: KJ
authors.lastname: Hunt
authors.forename: John
authors.initials: J
authors.lastname: Lachin
authors.forename: David
authors.initials: D
authors.lastname: Nathan
authors.forename: G
authors.initials: G
authors.lastname: Virella
mesh_terms: D000293:Adolescent; D000328:Adult; D000936:Antigen-Antibody Complex / Q000097:blood*; D002114:Calcinosis / Q000097:blood* / Q000000981:diagnostic imaging; D016009:Chi-Square Distribution; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000276:immunology*; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy / Q000276:immunology*; D003925:Diabetic Angiopathies / Q000000981:diagnostic imaging / Q000276:immunology*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D056724:Immunity, Humoral; D007328:Insulin / Q000627:therapeutic use; D008077:Lipoproteins, LDL / Q000097:blood / Q000276:immunology*; D012044:Regression Analysis; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014481:United States; D055815:Young Adult
chemical_list: D000936:Antigen-Antibody Complex; D007004:Hypoglycemic Agents; D007328:Insulin; D008077:Lipoproteins, LDL; C099252:oxidized low density lipoprotein