Journal Article

Elevated levels of plasma von Willebrand factor and the risk of macro‐ and microvascular disease in type 2 diabetic patients with microalbuminuria

Peter Gæde, Pernille Vedel, Hans‐Henrik Parving and Oluf Pedersen

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 16, issue 10, pages 2028-2033
Published in print October 2001 | ISSN: 0931-0509
Published online October 2001 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/16.10.2028
Elevated levels of plasma von Willebrand factor and the risk of macro‐ and microvascular disease in type 2 diabetic patients with microalbuminuria

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Background. The purpose of this study was to examine the concept suggesting that microalbuminuria in combination with high levels of plasma von Willebrand factor is a stronger predictor for cardiovascular disease and microvascular complications than microalbuminuria alone in type 2 diabetic patients.

Methods. One hundred and sixty patients with type 2 diabetes mellitus and persistent microalbuminuria were followed for an average of 3.8 (SD 0.3) years. 70% of the patients were treated with angiotensin converting enzyme (ACE)‐inhibitors. Patients in this subanalysis were divided into two groups according to baseline plasma von Willebrand factor levels below or above the median. The main outcome was cardiovascular disease (cardiovascular mortality, non‐fatal stroke, non‐fatal myocardial infarction, coronary artery bypass graft and revascularization or amputation of legs), progression to diabetic nephropathy or progression in diabetic retinopathy.

Results. At baseline the two groups were comparable for HbA1c, fasting levels of s‐total‐cholesterol, s‐HDL‐cholesterol and s‐triglycerides, systolic and diastolic blood pressure, gender, known diabetes duration, smoking habits, previous cardiovascular disease and antihypertensive therapy as well as retinopathy. Odds ratio for cardiovascular disease was 1.11 (95% CI 0.45–2.73, P=0.82) (multiple logistic regression), odds ratio for progression to nephropathy was 1.08 (0.41–2.85, P=0.87) and odds ratio for progression in retinopathy was 0.96 (0.46–2.00, P=0.92), all with plasma von Willebrand factor levels above the median.

Conclusions. Our results do not support the suggestion that the combination of high plasma levels of von Willebrand factor and microalbuminuria is a stronger predictor for cardiovascular disease, progression to diabetic nephropathy or progression in diabetic retinopathy than microalbuminuria alone in patients with type 2 diabetes and persistent microalbuminuria.

Keywords: cardiovascular disease; endothelial dysfunction; microalbuminuria; microvascular complications; type 2 diabetes mellitus; von Willebrand factor

Journal Article.  3421 words. 

Subjects: Nephrology

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