Increased Prevalence of Type 2 Diabetes–Related Complications in Combined Type 2 Diabetes and Sickle-Cell Trait
The prevalence of type 2 diabetes (T2D) is rapidly increasing in Sub-Saharan Africa,
where sickle-cell trait (SCT) is also frequent. Although SCT is generally considered a
benign condition, evidence suggests that SCT could exaggerate vascular dysfunction in T2D. However, it remains unclear whether SCT could increase the risk of
the development of T2D complications. Therefore, this study was conducted to
determine whether T2D complications were more prevalent among Senegalese
individuals with SCT and T2D than among those with T2D only.
RESEARCH DESIGN AND METHODS
Rates of hypertension, retinopathy, peripheral neuropathy, peripheral artery disease, and impaired renal function as well as arterial stiffness, blood rheology, and
concentrations of plasma advanced glycation end products (AGEs) and cytokines were compared between groups of Senegalese individuals with combined
SCT and T2D (T2D-SCT) (n = 60), T2D (n = 52), SCT (n = 53), and neither T2D nor SCT
(control) (n = 56). Human aortic endothelial cell (HAEC) expression of inflammatory
and adhesion factors were measured after treatment with tumor necrosis factor-a
and subjects’ plasma. Effects of AGE inhibition or tiron on HAEC expression of
E-selectin was measured.
Retinopathy, hypertension, and reduced renal function were more prevalent, and
arterial stiffness, blood viscosity at high shear rates, and thixotropic index were
higher in the SCT group compared with the other groups. Multivariable analysis
showed that plasma AGE concentration was significantly associated with arterial
stiffness. E-selectin expression was elevated in HAECs treated with T2D-SCT plasma
compared with the other groups, but AGE inhibition reversed this.
SCT could potentially augment the risk of the development of T2D-related
complications, including retinopathy, nephropathy, and hypertension.
Auteur(s) : Sarah C. Skinner,1,2 Mor Diaw,3 Vincent Pialoux,1,2,4 Ma¨?mouna Ndour Mbaye,5 Pauline Mury,1,2 Philomene Lopez, ` 6 Delphine Bousquet,7 Fatou Gueye,6
Année de publication : 2018
Revue : Diabetes Care
Type : Article
Mise en ligne par : GUEYE Fatou