Plasma alpha-defensin is associated with cardiovascular morbidity and mortality in type 1 diabetic patients

Gowsini Joseph, Lise Tarnow, Anne Sofie Astrup, Troels Krarup Hansen, Hans-Henrik Parving, Allan Flyvbjerg, Jan Frystyk

    33 Citationer (Scopus)

    Abstract

    CONTEXT: alpha-Defensins are antimicrobial peptides of the innate immune system. In addition, experimental evidence suggests that alpha-defensins are proatherogenic.

    OBJECTIVE: The objective of the study was to examine the predictive value of plasma alpha-defensin as a clinical marker of cardiovascular disease (CVD) in patients with type 1 diabetes.

    METHODS: In an observational, prospective design, 389 patients with long-lasting type 1 diabetes were examined for CVD at study start (1993; baseline) and followed up through the Danish National Register for a median of 10.1 yr (range 0.2-10.4 yr). Plasma was collected in 1993 and stored at -80 C until analysis of plasma alpha-defensin using an in-house RIA.

    RESULTS: At baseline, plasma alpha-defensin was significantly higher in patients with than without nephropathy [median and interquartile ranges: 305 (205-321) vs. 223 (182-263) mug/liter; P < 0.0001]. During follow-up, 98 patients reached the primary end point (fatal and nonfatal events of CVD). Prospectively a baseline alpha-defensin within the upper vs. the lower tertile significantly increased the covariate-adjusted risk for CVD-related morbidity and mortality to a hazard ratio of 2.8 (1.3-5.9) (median and 95% confidence intervals, P = 0.006).

    CONCLUSION: This study suggests that plasma alpha-defensin may serve as a clinical risk marker for CVD-related morbidity and mortality in type 1 diabetes. However, future studies are needed to clarify whether plasma alpha-defensin is causally linked to the development of CVD or an innocent bystander.

    OriginalsprogEngelsk
    TidsskriftThe Journal of clinical endocrinology and metabolism
    Vol/bind93
    Udgave nummer4
    Sider (fra-til)1470-5
    Antal sider6
    ISSN0021-972X
    DOI
    StatusUdgivet - apr. 2008

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