Anticardiolipin antibodies do not mediate macrovascular complications of type 2 diabetes

Caroline Eickhoff Copetti, Myriam Perreynoud, Melissa Claudia Bisi, Henrique Luiz Staub

Clinical Pathology Laboratory, S?o Lucas Hospital, PUCRS, Porto Alegre, Brazil.
Rheumatology Department, S?o Lucas Hospital, Faculty of Medicine, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.

DOI: 10.4236/ojim.2012.21009                

Abstract

The relationship of anticardiolipin antibodies (ACA), markers of the antiphospholipid syndrome, with vascular complications of diabetes mellitus is polemic. This cross-sectional study assessed the frequency of IgG, IgM, and IgA ACA in type 2 diabetics with and without history of vascular events for the last 5 years, and in healthy controls. ACA were detected by enzyme immunoassay. A total of 73 type 2 diabetics (33 with history of vascular events) and 54 healthy controls were tested. Most diabetics were female (p = 0.003), and older than controls (p < 0.001). Mean duration of disease was 10 years. The prevalence of a positive ACA test was 7.4% in controls and 9.5% in diabetics (p = 0.910). Comparison of healthy controls and diabetics with and without history of macrovasculopathy, after adjusting for gender and age, showed no significant differences as to the presence of ACA (p > 0.09). ACA positivity rates were also similar when diabetics with and without history of vasculopathy were compared (p > 0.47). After adjusting for gender, age, hypertension, and smoking status, a weak but statistically insignificant association between IgM ACA and diabetics with vasculopathy was found (adjusted OR 2.7; 95% CI 0.2 - 34.2; p = 0.441). Overall, levels of IgG (r = 0.25; p = 0.005) and IgM (r = 0.23; p = 0.010) ACA were associated with increasing age. In short, the frequency of a positive ACA test in type 2 diabetics (with or without previous macrovasculopathy) was not significant as compared to healthy controls. There was no association of ACA with vascular events in patients with type 2 diabetes.

Keywords

Anticardiolipin Antibodies; Type 2 Diabetes Mellitus; Myocardial Infarction; Cerebrovascular Infarction

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Miyakis, S., Lockshin, M.D., Atsumi, T., Branch, D.W., Brey, R.L., Cervera, R., et al. (2006) International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). Journal of Thrombosis and Haemostasis, 4, 295-306. doi:10.1111/j.1538-7836.2006.01753.x
[2]	Grundy, S.M., Cleeman, J.I., Daniels, S.R., Donato, K.A., Eckel, R.H., Franklin, B.A., et al. (2005) Diagnosis and management of the metabolic syndrome. An American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Executive summary. Cardiology in Review, 13, 322-327.
[3]	Gharavi, A.E., Harris, E.N., Asherson, R.A. and Hughes, G.R. (1987) Anticardiolipin antibodies: Isotype distribution and phospholipid specificity. Annals of the Rheumatic Diseases, 46, 1-6. doi:10.1136/ard.46.1.1
[4]	Chobanian, A.V., Bakris, G.L., Black, H.R., Cushman, W.C., Green, L.A., Izzo, J.L. Jr., et al. (2003) The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: The JNC 7 report. Journal of the American Medical Association, 289, 2560-2572. doi:10.1001/jama.289.19.2560
[5]	Filozof, C., Fernandez Pinilla, M.C. and Fernández-Cruz, A. (2004) Smoking cessation and weight gain. Obesity Research, 5, 95-103. doi:10.1111/j.1467-789X.2004.00131.x
[6]	King, H., Aubert, R.E. and Herman, W.H. (1998) Global burden of diabetes, 1995-2025: Prevalence, numerical estimates, and projections. Diabetes Care, 21, 1414-1431. doi:10.2337/diacare.21.9.1414
[7]	Kannel, W.B. and McGee, D.L. (1979) Diabetes and cardiovascular disease. The Framingham study. Journal of the American Medical Association, 241, 2035-2038. doi:10.1001/jama.1979.03290450033020
[8]	Ciarla, M.V., Bocciarelli, A., Di Gregorio, S., Tordi, A., Cotroneo, P., Marra, G., et al. (2001) Autoantibodies and endothelial dysfunction in well-controlled, uncomplicated insulin-dependent diabetes mellitus patients. Atherosclerosis, 158, 241-246. doi:10.1016/S0021-9150(01)00440-3
[9]	Staub, H.L., Norman, G.L., Crowther, T., Da Cunha, V.R., Polanczyk, A., Bohn, J.M., et al. (2003) Antibodies to the atherosclerotic plaque components beta2-glycoprotein I and heat-shock proteins as risk factors for acute cerebral ischemia. Arquivos De Neuro-Psiquitria, 61, 757-763. doi:10.1590/S0004-282X2003000500010
[10]	Ranzolin, A., Bohn, J.M., Norman, G.L., Manenti, E., Bodanese, L.C., Von Muhlen, C.A., et al. (2004) Anti-beta2-glycoprotein I antibodies as risk factors for acute myocardial infarction. Arquivos Brasileiros de Cardiologia, 83, 141-144.
[11]	Recuero, M.L., Silva, J.B., Norman, G.L., Von Muhlen, C.A. and Staub, H.L. (2007) IgA antibodies to beta2-glycoprotein I and carotid disease. Israel Medical Association Journal, 9, 495-496.
[12]	Franck, M., Staub, H.L., Petracco, J.B., Norman, G.L., Lassen, A.J., Schiavo, N., et al. (2007) Autoantibodies to the atheroma component beta2-glycoprotein I and risk of symptomatic peripheral artery disease. Angiology, 58, 295-302. doi:10.1177/0003319707302493
[13]	Krás Borges, R., Bodanese, L., Von Mühlen, C., Repetto, G., Viehe, M., Norman, G., et al. (2011) Anti-beta2-glycoprotein I autoantibodies and metabolic syndrome. Arquivos Brasileiros de Cardiologia, 96, 272-276.
[14]	Hendra, T.J., Baguley, E., Harris, E.N., Khamashta, M.H., Trembath, R.C., Hughes, G.R., et al. (1989) Anticardiolipin antibody levels in diabetic subjects with and without coronary artery disease. Postgraduate Medical Journal, 65, 140-143. doi:10.1136/pgmj.65.761.140
[15]	Gargiulo, P., Goldberg, J., Romani, B., Schiaffini, R., Ciampalini, P., Faulk, W.P., et al. (1999) Qualitative and quantitative studies of autoantibodies to phospholipids in diabetes mellitus. Clinical & Experimental Immunology, 118, 30-34. doi:10.1046/j.1365-2249.1999.01014.x
[16]	Galtier-Dereure, F., Biron, C., Vies, M., Bourgeois, V., Schved, J.F. and Bringer, J. (1998) Vascular complications of diabetes mellitus: What role for phospholipid-binding antibodies? Lupus, 7, 469-474. doi:10.1191/096120398678920488
[17]	Triolo, G., Giardina, E., Scarantino, G., Seddio, G. and Bompiani, G. (1989) Detection of anti-phospholipid (cardiolipin, phosphatidylserine) antibodies in the serum of patients with non insulin-dependent (type 2) diabetes mellitus and macroangiopathy. Coexistence of antiplatelet reactivity. Diabetes Research, 10, 63-67.
[18]	Fields, R.A., Toubbeh, H., Searles, R.P. and Bankhurst, A.D. (1989) The prevalence of anticardiolipin antibodies in a healthy elderly population and its association with antinuclear antibodies. Journal of Rheumatology, 16, 623-625.
[19]	Chakravarty, K.K., Gray, R.E., Webley, M., Byron, M.A. and Wozniak, J. (1991) Prevalence of anticardiolipin antibodies in the elderly British population. Postgraduate Medical Journal, 67, 358-361. doi:10.1136/pgmj.67.786.358
[20]	Tarkun, I., Hacihanefioglu, A., Tarkun, P., Cetinarslan, B. and Canturk, Z. (2005) Anticardiolipin and anti-beta2 glycoprotein I antibody concentrations in patients with type 2 diabetes mellitus. Diabetes Research and Clinical Practice, 68, 181-187. doi:10.1016/j.diabres.2004.09.005