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Association of the IGF1/pregnancy-associated plasma protein-A system and adipocytokine levels with the presence and the morphology of carotid plaques in type 2 diabetes mellitus patients with stable glycaemic control

¹ Endocrinology and Nutrition Service, Department of Internal Medicine, Universitat Autònoma de Barcelona, Germans Trias i Pujol University Hospital, 08916 Badalona, Barcelona, Spain² Clinical Biochemistry Service, Germans Trias i Pujol University Hospital, Badalona, Barcelona, Spain³ Endocrinology Unit, Mataró Hospital, Barcelona, Spain⁴ Hemotherapy and Hemostasis Service, Hospital Clinic, Barcelona, Spain

(Correspondence should be addressed to S Pellitero; Email: spellitero.germanstrias{at}gencat.cat)

Objective: Pregnancy-associated plasma protein-A (PAPP-A) has been implicated in the atherosclerotic process through regulation of local expression of IGF1. In type 2 diabetes mellitus, glycaemic control has been involved in PAPP-A expression. We compared PAPP-A, IGF1, inflammatory markers and adiponectin concentrations in type 2 diabetic patients with and without carotid plaques and evaluated the relationship between these serum parameters and ultrasound carotid markers of atherosclerosis.

Methods: We studied 125 consecutive type 2 diabetic patients. Clinical data, metabolic variables, hemostatic factors (plasma type-1 plasminogen activator inhibitor, fibrinogen), high-ultrasensitive C reactive protein (hsCRP), tumor necrosis factor (TNF)-, interleukin (IL)-6, adiponectin, IGF1 and PAPP-A were determined. Patients were classified into two groups according to the presence of carotid plaques on ultrasound. Carotid intima–media thickness (IMT) and morphology of carotid plaques were evaluated.

Results: The mean age was 61.5±7.3 years and the mean glycated hemoglobin of 6.8±0.9%. A total of 60% presented carotid plaques. Both groups were homogeneous in anthropometric data, biochemical determinations and hemostatic factors. Adiponectin, hsCRP, TNF- and IL-6 were similar in both groups. No differences were observed in serum PAPP-A (0.46 (0.22–0.86) vs 0.38 (0.18–0.66) mIU/l and in SDS IGF1 (–0.34±1.38 vs –0.67±1.35)) in patients with and without carotid plaques respectively. PAPP-A and IGF1 were not correlated with IMT.

Conclusions: Serum PAPP-A and IGF1 do not appear to be useful serum biomarkers for carotid atherosclerosis in type 2 diabetic patients with stable glycemic control, despite scientific evidence of their local role in atherosclerosis.