Longitudinal plasma kallikrein levels and their association with the risk of cardiovascular disease outcomes in type 1 diabetes in dcct/edic

Document Type

Journal Article

Publication Date

11-1-2020

Journal

Diabetes

Volume

69

Issue

11

DOI

10.2337/db20-0427

Abstract

We determined the relationship between plasma kalli-krein and cardiovascular disease (CVD) outcomes as well as major adverse cardiovascular events (MACE) in the Diabetes Control and Complications Trial (DCCT)/ Epidemiology of Diabetes Interventions and Complications (EDIC) cohort of type 1 diabetes (T1D). Plasma kallikrein levels were measured longitudinally in 693 subjects at DCCT baseline (1983–1989), midpoint (1988–1991), and end (1993) and at EDIC years 4–6 (1997–1999), 8–10 (2001–2003), and 11–13 (2004–2006). Cox proportional hazards regression models assessed the association between plasma kallikrein levels and the risk of CVD. In unadjusted models, higher plasma kallikrein levels were associated with higher risk of any CVD during DCCT/EDIC (hazard ratio [HR] 5 1.16 per 20 nmol/L higher levels of plasma kallikrein; P 5 0.0177) as well as over the EDIC-only period (HR 5 1.22; P 5 0.0024). The association between plasma kallikrein levels and the risk of any CVD remained significant during the EDIC follow-up after ad-justment for age and mean HbA1c (HR 5 1.20; P 5 0.0082) and in the fully adjusted model for other CVD risk factors (HR 5 1.17; P 5 0.0330). For MACE, higher plasma kallikrein levels were associated with higher risk in the unadjusted (HR 5 1.25; P 5 0.0145), minimally adjusted (HR 5 1.23; P 5 0.0417, and fully adjusted (HR 5 1.27; P 5 0.0328) models for EDIC only. These novel findings indicate that plasma kallikrein level associates with the risk of any CVD and MACE in T1D individuals.

Link to Full Text

Share

COinS