title: The relationship between serum hypoxia-inducible factor 1α and coronary artery calcification in asymptomatic type 2 diabetic patients.
abstract: BACKGROUND
  Hypoxia-inducible factor 1 (HIF-1), a master regulator of oxygen homeostasis, is a heterodimer consisting of HIF-1α and HIF-1β subunits, and is implicated in calcification of cartilage and vasculature. The goal of this study was to determine the relationship between serum HIF-1α with coronary artery calcification (CAC) in patients with type 2 diabetes.
  
  
  METHODS
  The subjects were 405 (262 males, 143 females, age 51.3 ± 6.4 years) asymptomatic patients with type 2 diabetes mellitus. Serum HIF-1α and interleukin-6 (IL-6) levels were measured by ELISA. CAC scores were assessed by a 320-slice CT scanner. The subjects were divided into 4 quartiles depending on serum HIF-1α levels.
  
  
  RESULTS
  Average serum HIF-1α was 184.4 ± 66.7 pg/ml. Among patients with higher CAC scores, HIF-1α levels were also significantly increased (p <0.001). HIF-1α levels positively correlated with CRP, IL-6, UKPDS risk score, HbA1c, FBG, and CACS, but did not correlate with diabetes duration, age, and LDL. According to the multivariate analysis, HIF-1α levels significantly and independently predict the presence of CAC. ROC curve analysis showed that the serum HIF-1α level can predict the extent of CAC, but the specificity was lower than the traditional risk factors UKPDS and HbA1c.
  
  
  CONCLUSIONS
  As a marker of hypoxia, serum HIF-1α level may be an independent risk factor for the presence of CAC. These findings indicate that elevated serum HIF-1α may be involved in vascular calcification in patients with type 2 diabetes mellitus.
authors.affiliation: Emergency Department, Wuhan General Hospital of Guangzhou Military Command, Wu Luo Road, Hong Shan, Wuhan, China. marty007@163.com.
authors.forename: Gang
authors.initials: G
authors.lastname: Li
authors.forename: Wei-hua
authors.initials: WH
authors.lastname: Lu
authors.forename: Rong
authors.initials: R
authors.lastname: Ai
authors.forename: Jian-hong
authors.initials: JH
authors.lastname: Yang
authors.forename: Fang
authors.initials: F
authors.lastname: Chen
authors.forename: Zhong-zhi
authors.initials: ZZ
authors.lastname: Tang
mesh_terms: D058070:Asymptomatic Diseases; D015415:Biomarkers / Q000097:blood; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000378:metabolism; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000175:diagnosis / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D051795:Hypoxia-Inducible Factor 1, alpha Subunit / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D061205:Vascular Calcification / Q000097:blood* / Q000175:diagnosis / Q000000981:diagnostic imaging*
chemical_list: D015415:Biomarkers; C497442:HIF1A protein, human; D051795:Hypoxia-Inducible Factor 1, alpha Subunit