Prognostic Values of Inflammation and Oxidative Stress Biomarkers on the Risk of Peripheral Arterial Disease in Type 2 Diabetes

Aim: We tested whether inflammation and oxidative stress biomarkers may predict the risk of peripheral arterial disease (PAD) in the SURDIAGENE (SURvie, DIAbete de type 2 et GENEtique) type 2 diabetes cohort. Methods: plasma concentrations of angiopoietin like 2 (ANGPTL2), TNF receptor 1 (TNFR1), fluorescent advanced glycation end products (F-AGE), advanced oxidation protein products (AOPP), protein carbonyl, ischemia-modified albumin (IMA), total reductive capacity of plasma (TRCP) and oxidative hemolysis inhibition assay (OxHLIA) were measured at baseline using ELISA, spectrofluorimetry, spectrophotometry and Folin-Ciocalteu methods. Cox model was fitted to assess the risk of severe PAD, requiring aortic or lower limb revascularization, by increasing tertiles of each biomarker at baseline adjusting for confounding variables. C-statistic was used to test PAD discrimination. Results: Among 1395 participants free for PAD at baseline (men 57%, mean±SD age 65±11 years, diabetes duration 14±10 years), aortic or lower limb revascularization was performed in 66 (4.7%) patients during 5.8±3.2 years of follow-up. The rate of revascularisation was higher in the upper tertiles (T2, T3) compared to the lower one (T1): TNFR1 (HR [95% CI] T2 vs. T1, 1.15 [1.01-1.32]; T3 vs. T1, 1.59 [1.34-1.88], trend p