title: Telomere length, antioxidant status and incidence of ischaemic heart disease in type 2 diabetes.
abstract: BACKGROUND
  Type 2 diabetes (T2D) is associated with an increased risk of ischaemic heart disease (IHD). An accelerated process of vascular ageing induced by an increased oxidative stress exposure is suggested as potential pathway accounting for this association. However, no studies have explored the relationship between markers of vascular ageing, measures of oxidative stress and risk of IHD in T2D.
  
  
  OBJECTIVE
  To explore the association between plasma antioxidant status, marker of cellular ageing (leukocyte telomere length, LTL) and 10years risk of IHD in patients with T2D.
  
  
  METHODS
  Between 2001 and 2002, 489 Caucasians subjects with T2D were enrolled at the diabetic clinic, University College London Hospital. Plasma total anti-oxidant status (TAOS) and LTL were measured by photometric microassay and RT-PCR, respectively. The incidence of IHD over 10years was determined through linkage with the national clinical audit of acute coronary syndrome in UK.
  
  
  RESULTS
  At baseline, TAOS was associated with LTL (age adjusted: r=0.106, p=0.024). After 10years, 61 patients developed IHD. Lower TAOS and shorter LTL at baseline predicted an increased IHD risk at follow-up (age adjusted: p=0.033 and p=0.040, respectively). These associations were independent of age, gender, cardiovascular risk factors, circulating levels of CRP and medication differences.
  
  
  CONCLUSIONS
  Reduced TAOS and short LTL are interrelated pathways which predict risk of IHD in patients with T2D. Our findings suggest that antioxidant defences are important to maintain telomere integrity, potentially reducing the progression of vascular ageing in patients with T2D.
authors.affiliation: National Centre for Cardiovascular Prevention and Outcomes (NCCPO), Institute of Cardiovascular Science, University College London, UK; Department of Clinical Gerontology, King's College London, UK. Electronic address: s.masi@ucl.ac.uk.
authors.forename: Stefano
authors.initials: S
authors.lastname: Masi
authors.affiliation: Periodontology Department, Eastman Dental Institute, University College London, UK.
authors.forename: Francesco
authors.initials: F
authors.lastname: D'Aiuto
authors.affiliation: Division of Cardiovascular Genetics, British Heart Foundation Laboratories, Institute of Cardiovascular Science, University College London, UK.
authors.forename: Jackie
authors.initials: J
authors.lastname: Cooper
authors.affiliation: Institute of Molecular Biology and Genetics, Biomedical Sciences Research Center "Alexander Fleming", Athens, Greece.
authors.forename: Klelia
authors.initials: K
authors.lastname: Salpea
authors.affiliation: Diabetes Research Group, College of Medicine, Swansea University, Swansea, UK.
authors.forename: Jeffrey W
authors.initials: JW
authors.lastname: Stephens
authors.affiliation: Department of Endocrinology, University College London Hospital, London, UK.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Hurel
authors.affiliation: National Centre for Cardiovascular Prevention and Outcomes (NCCPO), Institute of Cardiovascular Science, University College London, UK.
authors.forename: John E
authors.initials: JE
authors.lastname: Deanfield
authors.affiliation: Division of Cardiovascular Genetics, British Heart Foundation Laboratories, Institute of Cardiovascular Science, University College London, UK.
authors.forename: Steve E
authors.initials: SE
authors.lastname: Humphries
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000975:Antioxidants / Q000378:metabolism*; D016922:Cellular Senescence; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000453:epidemiology* / Q000235:genetics / Q000378:metabolism; D018384:Oxidative Stress; D010949:Plasma / Q000737:chemistry; D012307:Risk Factors; D016615:Telomere / Q000235:genetics*; D059505:Telomere Homeostasis
chemical_list: D000975:Antioxidants
keywords: Cardiovascular risk; Diabetes; Oxidative stress; Telomeres