title: Does diabetes accelerate the progression of aortic stenosis through enhanced inflammatory response within aortic valves?
abstract: Diabetes predisposes to aortic stenosis (AS). We aimed to investigate if diabetes affects the expression of selected coagulation proteins and inflammatory markers in AS valves. Twenty patients with severe AS and concomitant type 2 diabetes mellitus (DM) and 40 well-matched patients without DM scheduled for valve replacement were recruited. Valvular tissue factor (TF), TF pathway inhibitor (TFPI), prothrombin, C-reactive protein (CRP) expression were evaluated by immunostaining and TF, prothrombin, and CRP transcripts were analyzed by real-time PCR. DM patients had elevated plasma CRP (9.2 [0.74-51.9] mg/l vs. 4.7 [0.59-23.14] mg/l, p = 0.009) and TF (293.06 [192.32-386.12] pg/ml vs. 140 [104.17-177.76] pg/ml, p = 0.003) compared to non-DM patients. In DM group, TF-, TFPI-, and prothrombin expression within valves was not related to demographics, body mass index, and concomitant diseases, whereas increased expression related to DM was found for CRP on both protein (2.87 [0.5-9]% vs. 0.94 [0-4]%, p = 0.01) and transcript levels (1.3 ± 0.61 vs. 0.22 ± 0.43, p = 0.009). CRP-positive areas were positively correlated with mRNA TF (r = 0.84, p = 0.036). Diabetes mellitus is associated with enhanced inflammation within AS valves, measured by CRP expression, which may contribute to faster AS progression.
authors.affiliation: Institute of Cardiology, Jagiellonian University Medical College, 80 Pradnicka Str., 31-202 Kracow, Poland. j.natorska@szpitaljp2.krakow.pl
authors.forename: Joanna
authors.initials: J
authors.lastname: Natorska
authors.forename: Ewa
authors.initials: E
authors.lastname: Wypasek
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Grudzień
authors.forename: Dorota
authors.initials: D
authors.lastname: Sobczyk
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Marek
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Filip
authors.forename: Jerzy
authors.initials: J
authors.lastname: Sadowski
authors.forename: Anetta
authors.initials: A
authors.lastname: Undas
mesh_terms: D000368:Aged; D001021:Aortic Valve / Q000276:immunology* / Q000473:pathology*; D001024:Aortic Valve Stenosis / Q000150:complications* / Q000473:pathology; D002097:C-Reactive Protein / Q000032:analysis; D048909:Diabetes Complications / Q000473:pathology*; D003920:Diabetes Mellitus / Q000473:pathology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D007249:Inflammation; D008074:Lipoproteins / Q000032:analysis; D008297:Male; D008875:Middle Aged; D011516:Prothrombin / Q000032:analysis; D012333:RNA, Messenger / Q000235:genetics / Q000378:metabolism; D013925:Thromboplastin / Q000032:analysis
chemical_list: D008074:Lipoproteins; D012333:RNA, Messenger; C051928:lipoprotein-associated coagulation inhibitor; D011516:Prothrombin; D002097:C-Reactive Protein; D013925:Thromboplastin