Coronary artery calcification, arterial stiffness and renal insufficiency associate with serum levels of tumor necrosis factor-alpha in Japanese type 2 diabetic patients

• Published in: Diabetes research and clinical practice Vol. 82; no. 1; pp. 58 - 65
• Main Authors: Hirota, Takuo, Suzuki, Eiji, Ito, Isamu, Ishiyama, Masami, Goto, Shinobu, Horikawa, Yukio, Asano, Takahiko, Kanematsu, Masayuki, Hoshi, Hiroaki, Takeda, Jun
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier Ireland Ltd 01-10-2008
• Subjects: Arterial stiffness; Asian Continental Ancestry Group; Calcinosis - blood; Calcinosis - pathology; Coronary artery calcification; Coronary Artery Disease - blood; Coronary Artery Disease - pathology; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - ethnology; Diabetes Mellitus, Type 2 - pathology; Endocrinology & Metabolism; Female; Glomerular Filtration Rate; Humans; Japan; Kidney disease; Male; Middle Aged; Renal Insufficiency - blood; Renal Insufficiency - pathology; Tomography, X-Ray Computed; Tumor necrosis factor-alpha; Tumor Necrosis Factor-alpha - blood; Type 2 diabetes; Japan; Kidney disease; Type 2 diabetes; Coronary artery calcification; Tumor necrosis factor-alpha; Arterial stiffness
• ISSN: 0168-8227; 1872-8227
• DOI: 10.1016/j.diabres.2008.05.004

Abstract Although the kidneys are the major source of proinflammatory cytokines, association of tumor necrosis factor-alpha (TNF-α) with severity of atherosclerosis or kidney function in diabetic patients is unclear. Two hundred type 2 diabetic patients and 30 age-matched nondiabetic subjects consecutively admitted to our hospital were enrolled. The Agatston coronary artery calcium score (CACS), a quantitative marker of coronary atherosclerosis, was obtained using multidetector-row computed tomography. Arterial stiffness was assessed by brachial-ankle pulse wave velocity (baPWV). Diabetic patients had higher log(CACS + 1) ( p = 0.0089), baPWV ( p = 0.0293), frequency of elevated urinary albumin excretion (UAE) ( p < 0.0001) and TNF-α ( p = 0.0029) and similar estimated glomerular filtration rate (eGFR) compared to nondiabetic subjects. When diabetic patients were grouped into four subgroups with or without elevated UAE and renal insufficiency (UAE of ≥30 or <30 mg/24 h and eGFR of <60 or ≥60 ml/min per 1.73 m2 ), patients with micro- and macroalbuminuric renal insufficiency showed the highest log(CACS + 1) ( p < 0.0001), baPWV ( p = 0.0068) and TNF-α ( p < 0.0001) of these groups. Log(CACS + 1) ( p = 0.0008) and baPWV ( p = 0.0006) positively and eGFR ( p < 0.0001) negatively correlated with TNF-α in diabetic patients. We find that coronary artery calcification, arterial stiffness, and renal insufficiency associate with circulating levels of TNF-α in type 2 diabetic patients.