Autoantibodies against oxidized apolipoprotein (Apo) B peptides are potential biomarkers for diabetic retinopathy and peripheral neuropathy, while antibodies against the corresponding native peptides are potential biomarkers for macrovascular complications, report researchers in the journal Diabetologia.

There is increasing interest in identifying novel biomarkers that can be used to predict the risk of development of and monitor treatment for diabetic vascular complications.

Oxidation of low-density lipoprotein (LDL) plays a key role in the development of atherosclerosis and autoantibodies against oxidised LDL antigens such as Apo B have been linked with disease severity and the risk for developing acute cardiovascular events.

Jan Nilsson (Lund University, Malmo, Sweden) and colleagues investigated whether there is an association between autoantibodies against Apo B peptide sequences targeted by autoimmune responses (Apo B antigens p45 and p210) and vascular complications in patients with Type 2 diabetes, a disease associated with increased oxidative stress.

They assessed a total of 487 individuals with Type 2 diabetes and no history or symptoms of coronary heart disease, measuring their levels of oxidised LDL autoantibodies against native and immunogenic malondialdehyde (MDA)-modified Apo B peptides p45 and p210 using custom-made enzyme-linked immunosorbent assays.

Coronary artery calcium score was used as a surrogate marker for diabetic macrovascular complications and patients were stratified according to low-to-moderate or severe-to-extensive coronary calcification. Individuals were followed up for a mean of 2.5 years.

Patients affected by retinopathy had significantly higher levels of immunoglobulin (Ig)G against MDA-p45 and MDA-p210 than patients without retinopathy. They also had significantly higher levels of IgG against native p210 and a trend for higher IgG against native p45.

MDA-p210 IgG was also an independent predictor of the presence of neuropathy.

In contrast, patients with low-to-moderate coronary calcification had higher plasma levels of both IgG and IgM against native p45 and native p210 than patients with severe-to-extensive coronary calcification, but only IgG against p210 remained independently associated with the severity of coronary calcification after adjustment for confounding factors.

Follow-up imaging in 398 patients revealed that 119 (30%) patients with coronary calcium progression had lower plasma levels of IgG against native p45 than patients without progression; there was no association between antibodies against p210 and coronary calcium progression.

“The present observations suggest that autoantibodies against the MDA-modified ApoB peptide p210 are possible biomarkers for diabetic retinopathy and peripheral neuropathy, while antibodies against the corresponding native peptides are potential biomarkers for macrovascular complications,” conclude the authors.

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2009

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