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Coronary calcification, homocysteine, C-reactive protein and the metabolic syndrome in Type 2 diabetes: the Prospective Evaluation of Diabetic Ischaemic Heart Disease by Coronary Tomography (PREDICT) Study.
Diabet Med. 2006 Nov; 23(11):1192-200.DM

Abstract

AIMS

The PREDICT Study aims to determine: (i) the association between cardiovascular risk factors and coronary artery calcification score (CACS) obtained by electron beam tomography and (ii) the predictive value of CACS for coronary heart disease (CHD) events in Type 2 diabetes.

METHODS

Having previously reported relationships between CACS and conventional risk factors, we have now studied the novel risk factors, plasma high-sensitivity C-reactive protein (CRP) and homocysteine, insulin resistance, serum apoprotein A1 and B concentrations, the serum triglyceride/high-density lipoprotein cholesterol ratio and metabolic syndrome (International Diabetes Federation definition) in 573 subjects of the PREDICT Type 2 diabetes cohort.

RESULTS

In univariate analyses, the only significant positive novel correlate of CACS was homocysteine (P = 0.0004). CRP was increased in those with detectable calcification, but decreased with increasing calcification score (P = 0.006). In a multivariate model that included all significant univariate correlates, CACS was independently associated with age (P < 0.0001), waist-hip ratio (P < 0.02), male gender (P < 0.05) and duration of diabetes (P < 0.05), but the association with homocysteine was no longer significant. The negative association between CACS and CRP remained in multivariate analysis, and was independent of statin use.

CONCLUSIONS

Age was the major factor influencing CACS in Type 2 diabetes, with weaker contributions from waist hip-ratio and duration of diabetes. Other novel cardiovascular risk factors appear to have little positive effect.

Authors+Show Affiliations

Endocrinology and Metabolic Medicine, Imperial College London, London, UK. i.godsland@imperial.ac.ukNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17054594

Citation

Godsland, I F., et al. "Coronary Calcification, Homocysteine, C-reactive Protein and the Metabolic Syndrome in Type 2 Diabetes: the Prospective Evaluation of Diabetic Ischaemic Heart Disease By Coronary Tomography (PREDICT) Study." Diabetic Medicine : a Journal of the British Diabetic Association, vol. 23, no. 11, 2006, pp. 1192-200.
Godsland IF, Elkeles RS, Feher MD, et al. Coronary calcification, homocysteine, C-reactive protein and the metabolic syndrome in Type 2 diabetes: the Prospective Evaluation of Diabetic Ischaemic Heart Disease by Coronary Tomography (PREDICT) Study. Diabet Med. 2006;23(11):1192-200.
Godsland, I. F., Elkeles, R. S., Feher, M. D., Nugara, F., Rubens, M. B., Richmond, W., Khan, M., Donovan, J., Anyaoku, V., & Flather, M. D. (2006). Coronary calcification, homocysteine, C-reactive protein and the metabolic syndrome in Type 2 diabetes: the Prospective Evaluation of Diabetic Ischaemic Heart Disease by Coronary Tomography (PREDICT) Study. Diabetic Medicine : a Journal of the British Diabetic Association, 23(11), 1192-200.
Godsland IF, et al. Coronary Calcification, Homocysteine, C-reactive Protein and the Metabolic Syndrome in Type 2 Diabetes: the Prospective Evaluation of Diabetic Ischaemic Heart Disease By Coronary Tomography (PREDICT) Study. Diabet Med. 2006;23(11):1192-200. PubMed PMID: 17054594.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Coronary calcification, homocysteine, C-reactive protein and the metabolic syndrome in Type 2 diabetes: the Prospective Evaluation of Diabetic Ischaemic Heart Disease by Coronary Tomography (PREDICT) Study. AU - Godsland,I F, AU - Elkeles,R S, AU - Feher,M D, AU - Nugara,F, AU - Rubens,M B, AU - Richmond,W, AU - Khan,M, AU - Donovan,J, AU - Anyaoku,V, AU - Flather,M D, AU - ,, PY - 2006/10/24/pubmed PY - 2007/5/22/medline PY - 2006/10/24/entrez SP - 1192 EP - 200 JF - Diabetic medicine : a journal of the British Diabetic Association JO - Diabet Med VL - 23 IS - 11 N2 - AIMS: The PREDICT Study aims to determine: (i) the association between cardiovascular risk factors and coronary artery calcification score (CACS) obtained by electron beam tomography and (ii) the predictive value of CACS for coronary heart disease (CHD) events in Type 2 diabetes. METHODS: Having previously reported relationships between CACS and conventional risk factors, we have now studied the novel risk factors, plasma high-sensitivity C-reactive protein (CRP) and homocysteine, insulin resistance, serum apoprotein A1 and B concentrations, the serum triglyceride/high-density lipoprotein cholesterol ratio and metabolic syndrome (International Diabetes Federation definition) in 573 subjects of the PREDICT Type 2 diabetes cohort. RESULTS: In univariate analyses, the only significant positive novel correlate of CACS was homocysteine (P = 0.0004). CRP was increased in those with detectable calcification, but decreased with increasing calcification score (P = 0.006). In a multivariate model that included all significant univariate correlates, CACS was independently associated with age (P < 0.0001), waist-hip ratio (P < 0.02), male gender (P < 0.05) and duration of diabetes (P < 0.05), but the association with homocysteine was no longer significant. The negative association between CACS and CRP remained in multivariate analysis, and was independent of statin use. CONCLUSIONS: Age was the major factor influencing CACS in Type 2 diabetes, with weaker contributions from waist hip-ratio and duration of diabetes. Other novel cardiovascular risk factors appear to have little positive effect. SN - 0742-3071 UR - https://www.unboundmedicine.com/medline/citation/17054594/Coronary_calcification_homocysteine_C_reactive_protein_and_the_metabolic_syndrome_in_Type_2_diabetes:_the_Prospective_Evaluation_of_Diabetic_Ischaemic_Heart_Disease_by_Coronary_Tomography__PREDICT__Study_ L2 - https://doi.org/10.1111/j.1464-5491.2006.01950.x DB - PRIME DP - Unbound Medicine ER -