title: Risk of macrovascular complications in type 2 diabetes mellitus: endothelial microparticle profiles.
abstract: BACKGROUND
  While the adverse impact of diabetes on microvessels is well known, the risks of macroangiopathy are less well recognized. Here, we determine the differential risk and endothelial microparticle (EMP) profile of vascular complications in type 2 diabetes mellitus.
  
  
  METHODS
  Macroangiopathy was evaluated for cerebrovascular disease, coronary artery disease and peripheral artery disease; microangiopathy was evaluated for retinopathy, nephropathy and peripheral neuropathy. Clinical and laboratory factors were compared among 149 patients with no vascular complications or with microangiopathic and/or macroangiopathic complications. EMPs were also examined by flow cytometry using CD31, CD42b, annexin V (AV), and CD62E antibodies in the peripheral blood of patients.
  
  
  RESULTS
  Diabetes of long duration, an elevated hemoglobin A1c (HbA1c) and concomitant hypertension were significantly associated with the occurrence of vascular complications. Dyslipidemia and a high body mass index were significantly associated with macroangiopathy, while diabetes of long duration and a high concentration of HbA1c were associated with microangiopathy. The EMP (CD31+/CD42b-, CD31+/AV+) levels were higher in patients with macroangiopathy than in patients with microangiopathy and no complications. The EMP level was also independently associated with macroangiopathy in diabetic patients.
  
  
  CONCLUSIONS
  Microangiopathy and macroangiopathy in diabetic patients appear to have a different pathophysiological basis. The measurement of EMP would be helpful to differentiate the risk of diabetic vascular complications.
authors.affiliation: Department of Neurology, Clinical Research Institute, Seoul National University Hospital, Seoul, South Korea.
authors.forename: Keun-Hwa
authors.initials: KH
authors.lastname: Jung
authors.forename: Kon
authors.initials: K
authors.lastname: Chu
authors.forename: Soon-Tae
authors.initials: ST
authors.lastname: Lee
authors.forename: Jae-Jun
authors.initials: JJ
authors.lastname: Bahn
authors.forename: Jin-Hee
authors.initials: JH
authors.lastname: Kim
authors.forename: Manho
authors.initials: M
authors.lastname: Kim
authors.forename: Sang Kun
authors.initials: SK
authors.lastname: Lee
authors.forename: Jae-Kyu
authors.initials: JK
authors.lastname: Roh
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers; D002196:Capillaries / Q000473:pathology*; D055252:Cell-Derived Microparticles / Q000473:pathology*; D003627:Data Interpretation, Statistical; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000473:pathology*; D003925:Diabetic Angiopathies / Q000453:epidemiology; D004727:Endothelium / Q000473:pathology*; D005260:Female; D005434:Flow Cytometry; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008833:Microcirculation / Q000502:physiology*; D008875:Middle Aged; D012307:Risk Factors; D012959:Socioeconomic Factors; D014652:Vascular Diseases / Q000209:etiology
chemical_list: D015415:Biomarkers; D006442:Glycated Hemoglobin