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Association between renin and atherosclerotic burden in subjects with and without type 2 diabetes

Gonçalves, Isabel LU ; Edsfeldt, Andreas LU ; Colhoun, Helen M.; Shore, Angela C.; Palombo, Carlo; Natali, Andrea; Fredrikson, Gunilla Nordin LU ; Björkbacka, Harry LU ; Wigren, Maria LU and Bengtsson, Eva LU , et al. (2016) In BMC Cardiovascular Disorders 16(1). p.1-10
Abstract

Background: Activation of the renin-angiotensin-aldosterone-system (RAAS) has been proposed to contribute to development of vascular complications in type 2 diabetes (T2D). The aim of the present study was to determine if plasma renin levels are associated with the severity of vascular changes in subjects with and without T2D. Methods: Renin was analyzed by the Proximity Extension Assay in subjects with (n = 985) and without (n = 515) T2D participating in the SUMMIT (SUrrogate markers for Micro- and Macro-vascular hard endpoints for Innovative diabetes Tools) study and in 205 carotid endarterectomy patients. Vascular changes were assessed by determining ankle-brachial pressure index (ABPI), carotid intima-media thickness (IMT), carotid... (More)

Background: Activation of the renin-angiotensin-aldosterone-system (RAAS) has been proposed to contribute to development of vascular complications in type 2 diabetes (T2D). The aim of the present study was to determine if plasma renin levels are associated with the severity of vascular changes in subjects with and without T2D. Methods: Renin was analyzed by the Proximity Extension Assay in subjects with (n = 985) and without (n = 515) T2D participating in the SUMMIT (SUrrogate markers for Micro- and Macro-vascular hard endpoints for Innovative diabetes Tools) study and in 205 carotid endarterectomy patients. Vascular changes were assessed by determining ankle-brachial pressure index (ABPI), carotid intima-media thickness (IMT), carotid plaque area, pulse wave velocity (PWV) and the reactivity hyperemia index (RHI). Results: Plasma renin was elevated in subjects with T2D and demonstrated risk factor-independent association with prevalent cardiovascular disease both in subjects with and without T2D. Renin levels increased with age, body mass index, HbA1c and correlated inversely with HDL. Subjects with T2D had more severe carotid disease, increased arterial stiffness, and impaired endothelial function. Risk factor-independent associations between renin and APBI, bulb IMT, carotid plaque area were observed in both T2D and non-T2D subjects. These associations were independent of treatment with RAAS inhibitors. Only weak associations existed between plasma renin and the expression of pro-inflammatory and fibrous components in plaques from 205 endarterectomy patients. Conclusions: Our findings provide clinical evidence for associations between systemic RAAS activation and atherosclerotic burden and suggest that this association is of particular importance in T2D.

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published
subject
keywords
Arterial stiffness, Atherosclerosis, Endothelial dysfunction, Renin, Type 2 diabetes
in
BMC Cardiovascular Disorders
volume
16
issue
1
pages
10 pages
publisher
BioMed Central
external identifiers
  • scopus:84984992123
  • wos:000383207200001
ISSN
1471-2261
DOI
10.1186/s12872-016-0346-8
language
English
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yes
id
f7ae0c0f-a307-4ae6-8fee-cd778e3b8c09
date added to LUP
2016-09-29 16:23:05
date last changed
2017-01-01 08:35:33
@article{f7ae0c0f-a307-4ae6-8fee-cd778e3b8c09,
  abstract     = {<p>Background: Activation of the renin-angiotensin-aldosterone-system (RAAS) has been proposed to contribute to development of vascular complications in type 2 diabetes (T2D). The aim of the present study was to determine if plasma renin levels are associated with the severity of vascular changes in subjects with and without T2D. Methods: Renin was analyzed by the Proximity Extension Assay in subjects with (n = 985) and without (n = 515) T2D participating in the SUMMIT (SUrrogate markers for Micro- and Macro-vascular hard endpoints for Innovative diabetes Tools) study and in 205 carotid endarterectomy patients. Vascular changes were assessed by determining ankle-brachial pressure index (ABPI), carotid intima-media thickness (IMT), carotid plaque area, pulse wave velocity (PWV) and the reactivity hyperemia index (RHI). Results: Plasma renin was elevated in subjects with T2D and demonstrated risk factor-independent association with prevalent cardiovascular disease both in subjects with and without T2D. Renin levels increased with age, body mass index, HbA1c and correlated inversely with HDL. Subjects with T2D had more severe carotid disease, increased arterial stiffness, and impaired endothelial function. Risk factor-independent associations between renin and APBI, bulb IMT, carotid plaque area were observed in both T2D and non-T2D subjects. These associations were independent of treatment with RAAS inhibitors. Only weak associations existed between plasma renin and the expression of pro-inflammatory and fibrous components in plaques from 205 endarterectomy patients. Conclusions: Our findings provide clinical evidence for associations between systemic RAAS activation and atherosclerotic burden and suggest that this association is of particular importance in T2D.</p>},
  articleno    = {171},
  author       = {Gonçalves, Isabel and Edsfeldt, Andreas and Colhoun, Helen M. and Shore, Angela C. and Palombo, Carlo and Natali, Andrea and Fredrikson, Gunilla Nordin and Björkbacka, Harry and Wigren, Maria and Bengtsson, Eva and Östling, Gerd and Aizawa, Kunihiko and Casanova, Francesco and Persson, Margaretha and Gooding, Kim and Gates, Phil and Khan, Faisel and Looker, Helen C. and Adams, Fiona and Belch, Jill and Pinnola, Silvia and Venturi, Elena and Kozakova, Michaela and Gan, Li Ming and Schnecke, Volker and Nilsson, Jan},
  issn         = {1471-2261},
  keyword      = {Arterial stiffness,Atherosclerosis,Endothelial dysfunction,Renin,Type 2 diabetes},
  language     = {eng},
  month        = {09},
  number       = {1},
  pages        = {1--10},
  publisher    = {BioMed Central},
  series       = {BMC Cardiovascular Disorders},
  title        = {Association between renin and atherosclerotic burden in subjects with and without type 2 diabetes},
  url          = {http://dx.doi.org/10.1186/s12872-016-0346-8},
  volume       = {16},
  year         = {2016},
}