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. 2020 Aug;27(4):1352-1364.
doi: 10.1007/s12350-019-01842-5. Epub 2019 Aug 12.

Two-hour postload plasma glucose and pigment epithelium-derived factor levels are markers of coronary artery inflammation in type 2 diabetic patients

Nobuhiro Tahara  1 , Yoshikazu Nitta  2 , Munehisa Bekki  2 , Atsuko Tahara  2 , Shoko Maeda-Ogata  2 , Yoichi Sugiyama  2 , Akihiro Honda  2 , Sachiyo Igata  2 , Tomohisa Nakamura  2 , Jiahui Sun  2 , Seiji Kurata  3 , Kiminori Fujimoto  3 , Toshi Abe  3 , Takanori Matsui  4 , Sho-Ichi Yamagishi  5 , Yoshihiro Fukumoto  2
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Two-hour postload plasma glucose and pigment epithelium-derived factor levels are markers of coronary artery inflammation in type 2 diabetic patients

Nobuhiro Tahara et al. J Nucl Cardiol. 2020 Aug.

Abstract

Background: We have previously found that pioglitazone attenuates inflammation in the left main trunk of coronary artery (LMT), evaluated as target-to-background ratio (TBR) by 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) in patients with impaired glucose tolerance or type 2 diabetes.

Objectives: We assessed which clinical variables could predict the change in TBR in the LMT after 4-month add-on therapy with oral hypoglycemic agents (OHAs).

Methods: A total of 38 type 2 diabetic patients with carotid atherosclerosis who had already received OHAs except for pioglitazone was enrolled. At baseline and 4 months after add-on therapy with pioglitazone or glimepiride, all patients underwent 75 g oral glucose tolerance test, blood chemistry analysis, and FDG-PET/CT.

Results: Fasting plasma glucose, 30-, 60-, 90-, 120-minutes postload plasma glucose, HbA1c, and LMT-TBR values were significantly decreased by add-on therapy, whereas high-density lipoprotein-cholesterol and adiponectin levels were increased. Increased serum levels of pigment epithelium-derived factor (PEDF), a marker of insulin resistance and non-use of aspirin at baseline could predict the favorable response of LMT-TBR to add-on therapy. Moreover, Δ120-minutes postload plasma glucose and ΔPEDF were independent correlates of ΔLMT-TBR.

Conclusions: Our present study suggests that 120-minutes postload plasma glucose and PEDF values may be markers and potential therapeutic targets of coronary artery inflammation in type 2 diabetic patients.

Clinical trial registration: URL: http://clinicaltrials.gov . Unique identifier: NCT00722631. New markers for diabetes and CAD is on the horizon! Two-hour postload plasma glucose and pigment epithelium derived factor are markers of coronary artery inflammation in type 2 diabetic patients.

Keywords: 75 g OGTT; Coronary artery inflammation; FDG-PET; PEDF; insulin resistance.

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