Eur J Endocrinol. 2005 Nov;153(5):687-91. Related Articles, Links
The tumour necrosis factor (TNF)-alpha system is activated in
accordance with pulse pressure in normotensive subjects with type 1
diabetes mellitus.
Gonzalez-Clemente JM, Gimenez-Perez G, Richart C, Broch M, Caixas A,
Megia A, Gimenez-Palop O, Simon I, Mauricio D, Vendrell J.
Department of Diabetes, Endocrinology and Nutrition, Hospital de
Sabadell, Sabadell, Spain. [email hidden]
OBJECTIVE: Pulse pressure (PP) and inflammation are important
predictors of cardiovascular disease (CVD), even in the normotensive.
The age-related increase in PP can be diagnosed up to 20 years earlier
in subjects with type 1 diabetes mellitus (T1DM) than in the general
population. Some evidence suggests that PP can stimulate inflammation.
Our aim was to study the relationship between PP and plasma
inflammatory proteins in normotensive subjects with T1DM. DESIGN: This
was a cross-sectional study of a group of normotensive (<140/80 mmHg)
subjects diagnosed with T1DM 14 years before. None of them had
clinically proven CVD or inflammatory conditions or were on
antiplatelet, antihypertensive, anti-inflammatory or lipid-lowering
treatment. METHODS: The following information was recorded: sex, age,
body-mass index (BMI), waist-to-hip ratio (WHR), systolic blood
pressure (SBP), diastolic blood pressure (DBP), PP, mean blood pressure
(MBP), smoking, alcohol intake, insulin dose, lipid profile, HbA1c,
microvascular complications, and plasma concentrations of soluble
receptor types 1 and 2 of tumour necrosis factor (TNF)-alpha (sTNFR1
and sTNFR2, respectively), interleukin-6, C-reactive protein,
adiponectin and leptin. RESULTS: A total of 112 subjects were evaluated
(aged 27.4+/-6.6 years, 52.7% women, BMI: 20.4+/-2.7 kg/m2, WHR:
0.82+/-0.09, SBP: 112+/-12 mmHg, DBP: 68+/-9 mmHg, PP: 45+/-9 mmHg,
MBP: 82+/-9 mmHg, HbA1c: 8.2% (7.3-9.0%), 41.1% microvascular
complications). After adjusting for potential confounders, only
inflammatory markers of the TNF-alpha system correlated significantly
with PP (Pearson correlation coefficient between sTNFR1 and PP: r =
0.215, P = 0.030; and between PP and sTNFR2: r = 0.238, P = 0.020).
CONCLUSION: In normotensive subjects with T1DM after 14 years of
diagnosis, the activation of the TNF-alpha system is positively
associated with PP levels. This finding might suggest a pathogenic role
of the TNF-alpha system in the development of cardiovascular disease in
T1DM.
PMID: 16260427 [PubMed - indexed for MEDLINE]
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