Premium
Inverse correlation between activated protein C generation and carotid atherosclerosis in Type 2 diabetic patients
Author(s) -
Matsumoto K.,
Yano Y.,
Gabazza E. C.,
Araki R.,
Bruno N. E.,
Suematsu M.,
Akatsuka H.,
Katsuki A.,
Taguchi O.,
Adachi Y.,
Sumida Y.
Publication year - 2007
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.2007.02289.x
Subject(s) - medicine , conventional pci , endocrinology , intima media thickness , protein c , cardiology , carotid arteries , myocardial infarction
Aims Activated protein C (APC) is a key regulator of the clotting system and immune responses. We studied the relationship between the degree of atherosclerosis as measured by the intima‐media thickness (IMT) of carotid artery and APC generation in Type 2 diabetic patients. Methods Eighty‐seven Type 2 diabetic patients and 35 control subjects participated. APC generation was assessed by the plasma APC–protein C inhibitor complex (APC‐PCI) levels and the mean IMT of carotid artery was measured by ultrasonography. The plasma levels of the thrombin–anti‐thromobin complex (TAT) and platelet‐derived growth factor (PDGF) were measured by enzyme‐linked immunoassays. Results Plasma TAT levels were significantly higher in diabetic patients [2.03 (1.12, 2.56) ng/ml, median (25th, 75th percentile)] compared with control subjects [0.85 (0.55, 2.08) ng/ml, P < 0.01]. Plasma APC‐PCI levels were significantly lower in diabetic patients [0.93 (0.74, 1.22) ng/ml], than in control subjects [1.66 (1.25, 2.36) ng/ml, P < 0.001]. The mean IMT was significantly increased in diabetic patients (0.881 ± 0.242 mm; mean ± sd ) compared with control subjects (0.669 ± 0.140 mm; P < 0.01). Univariate analysis showed a significant and inverse correlation between plasma APC‐PCI levels and mean IMT ( r = – 0.32, P < 0.005), and multivariate regression analysis confirmed the independent correlation ( P < 0.05). Moreover, plasma APC‐PCI levels significantly and inversely correlated with plasma PDGF levels in diabetic patients ( r = –0.30, P < 0.01). Conclusions These results suggest that decreased APC generation is associated with vascular atherosclerotic changes in Type 2 diabetic patients.