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. 2020 Oct 29;21(21):8075.
doi: 10.3390/ijms21218075.

Determinants of Increased Serum Calprotectin in Patients with Type 2 Diabetes Mellitus

Milou M Oosterwijk  1 , Stephan J L Bakker  2 , Tom Nilsen  3 , Gerjan Navis  2 , Gozewijn D Laverman  1   2
Affiliations

Determinants of Increased Serum Calprotectin in Patients with Type 2 Diabetes Mellitus

Milou M Oosterwijk et al. Int J Mol Sci. .

Abstract

Circulating calprotectin is a potential biomarker for endovascular inflammation in type 2 diabetes mellitus (T2DM). We investigated the determinants of calprotectin and its relationship with the presence of cardiovascular disease (CVD) in 362 T2DM patients included in the Diabetes and Lifestyle Cohort Twente-1 (DIALECT-1) study. Lifestyle exposures, including nutrition, were determined by validated questionnaires. CVD was defined as coronary artery diseases, strokes, and peripheral artery diseases. Median serum calprotectin levels were 1.04 mg/L [IQR: 0.73-1.46 mg/L] and were higher in women (1.11 mg/L) than men (0.96 mg/L, p = 0.007). Current smoking was a major independent determinant of circulating calprotectin, with a 51% higher calprotectin compared to never smoking (p < 0.001). Albuminuria (p = 0.011), former smoking (p = 0.023), and intake of mono- and disaccharides (p = 0.005) also contributed independently to circulating calprotectin. Each incremental increase in calprotectin level was associated with 1.36-times higher odds for CVD (95% CI 1.04-1.77, p = 0.026). In the current study, calprotectin was the only inflammatory parameter significantly associated with CVD. The strong association of circulating calprotectin with smoking, a well-known direct cause of vascular inflammation, and also with CVD, stresses the urge for further research to define its role as a biomarker in T2DM.

Keywords: biomarker; calprotectin; cardiovascular diseases; endovascular inflammation; lifestyle; smoking; type 2 diabetes mellitus.

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Conflict of interest statement

G.D.L. has received lecture fees from Sanofi, Astra Zeneca, and Jansen, and has served as a consultant for Abbvie, Sanofi, Novo Nordisk, Astra Zeneca, Boehringer Ingelheim, and MSD. Tom Nilsen works in Gentian Diagnostics AS which has developed and has the commercial rights for the gCAL assay applied to determine the serum calprotectin concentrations.

Figures

Figure 1
Figure 1
Scatterplots between log calprotectin and various inflammation parameters: (a) Scatterplot between log calprotectin and leukocytes (109/L); (b) Scatterplot between log calprotectin and thrombocytes (109/L); (c) Scatterplot between log calprotectin and log CRP (mg/L); (d) Scatterplot between log calprotectin and serum albumin (g/L).
Figure 2
Figure 2
Forest plot with serum inflammation parameters as predictors for CVD in 362 patients with T2DM in the DIALECT-1 population.
See this image and copyright information in PMC

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