title: Activin A and cardiovascular disease in type 2 diabetes mellitus.
abstract: BACKGROUND
  Silent coronary artery disease is a frequent complication of type 2 diabetes (T2DM). Based on its multiple roles in inflammation, atherogenesis and glucose homeostasis, we hypothesised that activin A could be related to coronary atherosclerosis in T2DM.
  
  
  METHODS
  Activin A and follistatin were measured in 102 patients with T2DM and 20 age- and sex-matched healthy controls. Coronary angiography was performed in a sub-population of patients and associations with activin A were examined using multiple linear regression.
  
  
  RESULTS
  Serum activin A and the activin A/follistatin ratio were increased in patients with T2DM and coronary artery disease (CAD) compared with healthy volunteers and the elevated activin A was associated with the severity of coronary atherosclerotic burden as determined by the proportion of ≥2 vessel disease (p = 0.035) after multivariable-adjusted trend analysis. No significant association between presence of CAD or extent score and activin A was observed.
  
  
  CONCLUSIONS
  In patients with T2DM, increased activin A may reflect chronic underlying pathophysiological processes involved in development of cardiovascular disease.
authors.affiliation: Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Norway. thor.ueland@medisin.uio.no
authors.forename: Thor
authors.initials: T
authors.lastname: Ueland
authors.forename: Pål
authors.initials: P
authors.lastname: Aukrust
authors.forename: Svend
authors.initials: S
authors.lastname: Aakhus
authors.forename: Camilla
authors.initials: C
authors.lastname: Smith
authors.forename: Knut
authors.initials: K
authors.lastname: Endresen
authors.forename: Kåre I
authors.initials: KI
authors.lastname: Birkeland
authors.forename: Lars
authors.initials: L
authors.lastname: Gullestad
authors.forename: Odd Erik
authors.initials: OE
authors.lastname: Johansen
mesh_terms: D028341:Activins / Q000378:metabolism*; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000209:etiology / Q000378:metabolism*; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000378:metabolism*; D005260:Female; D038681:Follistatin / Q000378:metabolism*; D006801:Humans; D007249:Inflammation / Q000378:metabolism*; D016014:Linear Models; D008297:Male; D008875:Middle Aged
chemical_list: D038681:Follistatin; C422405:activin A; D028341:Activins