title: Renal AA Amyloidosis in Patients with Type 2 Diabetes Mellitus.
abstract: BACKGROUND
  Type 2 diabetes mellitus (T2DM) is the leading cause of chronic kidney disease and a major cause of cardiovascular disease (CVD) mortality. Inflammation is closely involved in the pathogenesis of T2DM, and reactive amyloidosis occurs in the presence of chronic inflammation. We hypothesized that patients with T2DM may have a higher prevalence of renal AA amyloidosis (RAAA) and that this could contribute to worse atherosclerosis and CVD.
  
  
  METHODS
  We analyzed 330 autopsy kidneys from patients with a previous T2DM diagnosis. The kidney tissue was evaluated in order to determine the presence of diabetic nephropathy and RAAA, and systemic vessels were evaluated for the presence of atherosclerosis.
  
  
  RESULTS
  RAAA was detected in 9% of our study population and was associated with an increased risk for nodular sclerosis [OR (95% CI)] [11 (2.04-59.16)], for chronic ischemic cardiomyopathy [4.59 (2.02-10.42)], for myocardial infarction [3.41 (1.52-7.64)] as well as for aortic [4.75 (1.09-20.69)], coronary [3.22 (1.47-7.04)], and intrarenal atherosclerosis [3.84 (1.46-10.09)].
  
  
  CONCLUSIONS
  RAAA is prevalent in T2DM and is associated with worse CVD and renal disease, likely because RAAA is a marker of severe chronic inflammation.
authors.affiliation: Department of Nephrology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico.
authors.forename: Ramón
authors.initials: R
authors.lastname: Díez
authors.affiliation: Department of Nephrology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Madero
authors.affiliation: Department of Molecular Physiology Unit, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico ; Department of Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City, Mexico.
authors.forename: Gerardo
authors.initials: G
authors.lastname: Gamba
authors.affiliation: Department of Medicine Faculty, Universidad Nacional Autónoma de México, Mexico City, Mexico ; Department of Pathology, Hospital General de México, Mexico City, Mexico.
authors.forename: Juan
authors.initials: J
authors.lastname: Soriano
authors.affiliation: Department of Pathology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico ; Department of Pathology, Hospital General de México, Mexico City, Mexico.
authors.forename: Virgilia
authors.initials: V
authors.lastname: Soto
keywords: Advanced glycation end products; Atherosclerosis; Diabetic nephropathy; Serum amyloid A