TY - JOUR
T1 - Circulating Receptor Activator of Nuclear Factor kB Ligand and triglycerides are associated with progression of lower limb arterial calcification in type 2 diabetes
T2 - a prospective, observational cohort study
AU - Bourron, Olivier
AU - Phan, Franck
AU - Diallo, Mamadou Hassimiou
AU - Hajage, David
AU - Aubert, Carole-Elodie
AU - Carlier, Aurelie
AU - Salem, Joe-Elie
AU - Funck-Brentano, Christian
AU - Kemel, Salim
AU - Cluzel, Philippe
AU - Redheuil, Alban
AU - Davaine, Jean-Michel
AU - Massy, Ziad
AU - Mentaverri, Romuald
AU - Bonnefont-Rousselot, Dominique
AU - Gillery, Philippe
AU - Jaisson, Stephane
AU - Vermeer, Cees
AU - Lacorte, Jean-Marc
AU - Bouziri, Nesrine
AU - Laroche, Suzanne
AU - Amouyal, Chloe
AU - Hartemann, Agnes
PY - 2020/9/18
Y1 - 2020/9/18
N2 - Background Lower limb arterial calcification is a frequent, underestimated but serious complication of diabetes. The DIACART study is a prospective cohort study designed to evaluate the determinants of the progression of lower limb arterial calcification in 198 patients with type 2 diabetes. Methods Lower limb arterial calcification scores were determined by computed tomography at baseline and after a mean follow up of 31.20 +/- 3.86 months. Serum RANKL (Receptor Activator of Nuclear factor kB Ligand) and bone remodeling, inflammatory and metabolic parameters were measured at baseline. The predictive effect of these markers on calcification progression was analyzed by a multivariate linear regression model. Results At baseline, mean +/- SD and median lower limb arterial calcification scores were, 2364 +/- 5613 and 527 respectively and at the end of the study, 3739 +/- 6886 and 1355 respectively. Using multivariate analysis, the progression of lower limb arterial log calcification score was found to be associated with (beta coefficient [slope], 95% CI, p-value) baseline log(calcification score) (1.02, 1.00-1.04, p <0.001), triglycerides (0.11, 0.03-0.20, p = 0.007), log(RANKL) (0.07, 0.02-0.11, p = 0.016), previous ischemic cardiomyopathy (0.36, 0.15-0.57, p = 0.001), statin use (0.39, 0.06-0.72, p = 0.023) and duration of follow up (0.04, 0.01-0.06, p = 0.004). Conclusion In patients with type 2 diabetes, lower limb arterial calcification is frequent and can progress rapidly. Circulating RANKL and triglycerides are independently associated with this progression. These results open new therapeutic perspectives in peripheral diabetic calcifying arteriopathy. Trial registrationNCT02431234
AB - Background Lower limb arterial calcification is a frequent, underestimated but serious complication of diabetes. The DIACART study is a prospective cohort study designed to evaluate the determinants of the progression of lower limb arterial calcification in 198 patients with type 2 diabetes. Methods Lower limb arterial calcification scores were determined by computed tomography at baseline and after a mean follow up of 31.20 +/- 3.86 months. Serum RANKL (Receptor Activator of Nuclear factor kB Ligand) and bone remodeling, inflammatory and metabolic parameters were measured at baseline. The predictive effect of these markers on calcification progression was analyzed by a multivariate linear regression model. Results At baseline, mean +/- SD and median lower limb arterial calcification scores were, 2364 +/- 5613 and 527 respectively and at the end of the study, 3739 +/- 6886 and 1355 respectively. Using multivariate analysis, the progression of lower limb arterial log calcification score was found to be associated with (beta coefficient [slope], 95% CI, p-value) baseline log(calcification score) (1.02, 1.00-1.04, p <0.001), triglycerides (0.11, 0.03-0.20, p = 0.007), log(RANKL) (0.07, 0.02-0.11, p = 0.016), previous ischemic cardiomyopathy (0.36, 0.15-0.57, p = 0.001), statin use (0.39, 0.06-0.72, p = 0.023) and duration of follow up (0.04, 0.01-0.06, p = 0.004). Conclusion In patients with type 2 diabetes, lower limb arterial calcification is frequent and can progress rapidly. Circulating RANKL and triglycerides are independently associated with this progression. These results open new therapeutic perspectives in peripheral diabetic calcifying arteriopathy. Trial registrationNCT02431234
KW - Arterial calcification
KW - Biomarkers
KW - Calcium score
KW - Mediacalcosis
KW - Peripheral artery disease
KW - Type 2 diabetes
KW - KAPPA-B LIGAND
KW - MATRIX GLA PROTEIN
KW - VASCULAR CALCIFICATION
KW - OSTEOPROTEGERIN
KW - CALCIUM
KW - RANKL
KW - DISEASE
KW - PREDICT
KW - MARKER
KW - RISK
U2 - 10.1186/s12933-020-01122-4
DO - 10.1186/s12933-020-01122-4
M3 - Article
C2 - 32948184
SN - 1475-2840
VL - 19
JO - Cardiovascular Diabetology
JF - Cardiovascular Diabetology
IS - 1
M1 - 140
ER -