title: Type 2 diabetes is not associated with an altered plaque phenotype among patients undergoing carotid revascularization. A histological analysis of 1455 carotid plaques.
abstract: OBJECTIVE
  Diabetes accelerates progression of atherosclerotic disease, but data on associations between diabetes and advanced atherosclerotic plaque composition are scarce.
  
  
  RESULTS
  We used one of the largest biobanks, the Athero-Express study (n=1455) at carotid endarterectomy (CEA). All plaques were subjected to histological analysis to assess lipid core size, collagen, macrophages, smooth muscle cells, micro-vessel density and calcifications. In addition, within a subset of patients cytokines and chemokines were assessed. The 295 patients (20%) with type-2 diabetes showed a higher proportion of previous cardiovascular interventions and more stringent treatment for hypertension and hypercholesterolaemia compared with patients without type-2 diabetes. Surprisingly, no associations between diabetes and histological plaque characteristics were observed. In addition, no differences were observed in the expression of inflammatory chemokines, cytokines or advanced glycation end products in plaques of diabetic and non-diabetic patients.
  
  
  CONCLUSIONS
  In patients suffering from significant carotid artery disease, diabetes does not appear to be associated with specific atherosclerotic plaque characteristics.
authors.affiliation: Experimental Cardiology Laboratory, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
authors.forename: Vincent P W
authors.initials: VP
authors.lastname: Scholtes
authors.affiliation: Experimental Cardiology Laboratory, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
authors.forename: Wouter
authors.initials: W
authors.lastname: Peeters
authors.affiliation: Experimental Cardiology Laboratory, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
authors.forename: Guus W
authors.initials: GW
authors.lastname: van Lammeren
authors.affiliation: Department of Clinical Neurology, Stroke Prevention Research Unit, Radcliffe Infirmary, Oxford, UK.
authors.forename: Dominic P J
authors.initials: DP
authors.lastname: Howard
authors.affiliation: Department of Vascular Surgery, St Antonius Hospital, Nieuwegein, The Netherlands.
authors.forename: Jean-Paul P M
authors.initials: JP
authors.lastname: de Vries
authors.affiliation: Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Gert Jan
authors.initials: GJ
authors.lastname: de Borst
authors.affiliation: Department of Clinical Neurology, Stroke Prevention Research Unit, Radcliffe Infirmary, Oxford, UK.
authors.forename: Jessica N
authors.initials: JN
authors.lastname: Redgrave
authors.affiliation: Department of Clinical Chemistry, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Hans
authors.initials: H
authors.lastname: Kemperman
authors.affiliation: Department of Internal Medicine, Laboratory of Metabolism and Vascular Medicine, Maastricht, The Netherlands; Cardiovascular Research Institute, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Casper G
authors.initials: CG
authors.lastname: Schalkwijk
authors.affiliation: Experimental Cardiology Laboratory, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Hester M
authors.initials: HM
authors.lastname: den Ruijter
authors.affiliation: Experimental Cardiology Laboratory, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
authors.forename: Dominique P V
authors.initials: DP
authors.lastname: de Kleijn
authors.affiliation: Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Frans L
authors.initials: FL
authors.lastname: Moll
authors.affiliation: Department of Clinical Neurology, Stroke Prevention Research Unit, Radcliffe Infirmary, Oxford, UK.
authors.forename: Peter M
authors.initials: PM
authors.lastname: Rothwell
authors.affiliation: Experimental Cardiology Laboratory, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands. Electronic address: g.pasterkamp@umcutrecht.nl.
authors.forename: Gerard
authors.initials: G
authors.lastname: Pasterkamp
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D016894:Endarterectomy, Carotid; D058226:Plaque, Atherosclerotic / Q000473:pathology* / Q000503:physiopathology
keywords: Carotid endarterectomy; Carotid plaque; Diabetes; Histology