Prevalence and progression of peripheral vascular calcification in type 2 diabetes subjects with preserved kidney function.
Diabetes research and clinical practice 2012 Mar 2; In press
Singh DK, Winocour P, Summerhayes B, Kaniyur S, Viljoen A, Sivakumar G, Farrington K
Renal Unit, East and North Herts NHS Trust, SG1 4AB, UK; Diabetes and Endocrinology, East and North Herts NHS Trust, SG1 4AB, UK.
AIMS: To determine predictors of prevalence and progression of peripheral vascular calcification (VC) in type 2 diabetes (DM) subjects with preserved kidney function. METHODS: Fifty-eight subjects (age 63±11.6 years) with type 2 DM and serum creatinine <125μmol/l were studied. A CT scan of femoral, posterior tibial and dorsalis pedis arteries was carried out at baseline and at one year. Serum osteoprotegerin (OPG) and RANKL were measured along with routine biochemistry. RESULTS: Seventy-eight percent of patients had baseline VC, 47% with femoral VC, 49% with VC at two sites - femoral and foot, and 4% foot VC alone. Age, ethnicity, peripheral neuropathy and eGFR were independent predictors of baseline VC. Baseline calcification was the most important predictor of VC progression and was present in all subjects with progression compared to 35% of non-progressors (p<0.001). Exclusion of demographic factors from models revealed neuropathy and serum OPG levels as independent predictors of both; baseline VC and progression. CONCLUSIONS: Subjects with type 2 DM and well-preserved renal function had a high prevalence of VC, which was rapidly progressive especially in those with baseline VC. Age, ethnicity, neuropathy, smoking and eGFR were predictors of baseline VC and progression.