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01-12-2020 | Arterial Diseases | Original investigation

Circulating Receptor Activator of Nuclear Factor kB Ligand and triglycerides are associated with progression of lower limb arterial calcification in type 2 diabetes: a prospective, observational cohort study

Authors: Olivier Bourron, Franck Phan, Mamadou Hassimiou Diallo, David Hajage, Carole-Elodie Aubert, Aurélie Carlier, Joe-Elie Salem, Christian Funck-Brentano, Salim Kemel, Philippe Cluzel, Alban Redheuil, Jean-Michel Davaine, Ziad Massy, Romuald Mentaverri, Dominique Bonnefont-Rousselot, Philippe Gillery, Stéphane Jaisson, Cees Vermeer, Jean-Marc Lacorte, Nesrine Bouziri, Suzanne Laroche, Chloé Amouyal, Agnes Hartemann

Published in: Cardiovascular Diabetology | Issue 1/2020

Abstract

Background

Lower limb arterial calcification is a frequent, underestimated but serious complication of diabetes. The DIACART study is a prospective cohort study designed to evaluate the determinants of the progression of lower limb arterial calcification in 198 patients with type 2 diabetes.

Methods

Lower limb arterial calcification scores were determined by computed tomography at baseline and after a mean follow up of 31.20 ± 3.86 months. Serum RANKL (Receptor Activator of Nuclear factor kB Ligand) and bone remodeling, inflammatory and metabolic parameters were measured at baseline. The predictive effect of these markers on calcification progression was analyzed by a multivariate linear regression model.

Results

At baseline, mean ± SD and median lower limb arterial calcification scores were, 2364 ± 5613 and 527 respectively and at the end of the study, 3739 ± 6886 and 1355 respectively. Using multivariate analysis, the progression of lower limb arterial log calcification score was found to be associated with (β coefficient [slope], 95% CI, p-value) baseline log(calcification score) (1.02, 1.00–1.04, p < 0.001), triglycerides (0.11, 0.03–0.20, p = 0.007), log(RANKL) (0.07, 0.02–0.11, p = 0.016), previous ischemic cardiomyopathy (0.36, 0.15–0.57, p = 0.001), statin use (0.39, 0.06–0.72, p = 0.023) and duration of follow up (0.04, 0.01–0.06, p = 0.004).

Conclusion

In patients with type 2 diabetes, lower limb arterial calcification is frequent and can progress rapidly. Circulating RANKL and triglycerides are independently associated with this progression. These results open new therapeutic perspectives in peripheral diabetic calcifying arteriopathy.

Trial registration NCT02431234

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Title: Circulating Receptor Activator of Nuclear Factor kB Ligand and triglycerides are associated with progression of lower limb arterial calcification in type 2 diabetes: a prospective, observational cohort study
Authors: Olivier Bourron
Franck Phan
Mamadou Hassimiou Diallo
David Hajage
Carole-Elodie Aubert
Aurélie Carlier
Joe-Elie Salem
Christian Funck-Brentano
Salim Kemel
Philippe Cluzel
Alban Redheuil
Jean-Michel Davaine
Ziad Massy
Romuald Mentaverri
Dominique Bonnefont-Rousselot
Philippe Gillery
Stéphane Jaisson
Cees Vermeer
Jean-Marc Lacorte
Nesrine Bouziri
Suzanne Laroche
Chloé Amouyal
Agnes Hartemann
Publication date: 01-12-2020
Publisher: BioMed Central
Keywords: Arterial Diseases
Type 2 Diabetes
Published in: Cardiovascular Diabetology / Issue 1/2020
Electronic ISSN: 1475-2840
DOI: https://doi.org/10.1186/s12933-020-01122-4

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