Association of the anti-angiogenic factor secreted protein and rich in cysteine (SPARC) with vascular complications among Chinese type 2 diabetic patients in Singapore.
AIMS
This study evaluated the association of the anti-angiogenic SPARC with known angiogenesis-associated factors and diabetes-related micro- and macro-vascular complications in a Singapore Chinese cohort with type 2 diabetes (T2DM).


METHODS
Plasma SPARC was measured by immunoassay in 438 T2DM adults (mean age:58±11years).


RESULTS
Higher SPARC levels in subjects stratified by SPARC tertiles displayed decreased pro-angiogenic adiponectin, osteopontin, vascular cell adhesion molecule (VCAM)-1 and matrix metalloproteinase (MMP)-2 concentrations (all p<0.05). The anti-angiogenic pigment epithelium-derived factor (PEDF) level was not statistically different among the SPARC tertiles. Age-adjusted partial correlation revealed significant associations of SPARC with adiponectin, osteopontin, VCAM-1, MMP-2, and PEDF (all p<0.05). Lower SPARC was accompanied by less favorable estimated glomerular filtration rate (eGFR) and carotid-femoral pulse wave velocity (PWV) readings (all p<0.05). Conversely, ankle-brachial index (ABI) reduced with increasing SPARC (p=0.048). The eGFR (B=0.834, p=0.019), PWV (B=-7.925, p=0.009), and ABI (B=-142.160, p=0.010) remained as determinants of SPARC after confounder adjustment. Moreover, individuals in the lowest SPARC tertile had increased odds of aortic stiffness (OR=1.900, 95% CI=1.103-3.274) but reduced odds of peripheral arterial disease (OR=0.400, 95% CI=0.175-0.919). However, SPARC was not independently associated with chronic kidney disease.


CONCLUSIONS
The anti-angiogenic SPARC may be associated with the pathophysiology of diabetes-related macrovascular complications.
['Moh|Mei Chung|MC|', 'Sum|Chee Fang|CF|', 'Tavintharan|Subramaniam|S|', 'Pek|Sharon Li Ting|SLT|', 'Yeoh|Lee Ying|LY|', 'Ng|Xiaowei|X|', 'Lee|Simon Biing Ming|SBM|', 'Tang|Wern Ee|WE|', 'Lim|Su Chi|SC|']
D000368:Aged D055109:Ankle Brachial Index D001018:Aortic Diseases D044466:Asians D015415:Biomarkers D015331:Cohort Studies D003430:Cross-Sectional Studies D003924:Diabetes Mellitus, Type 2 D003925:Diabetic Angiopathies D015536:Down-Regulation D005260:Female D006801:Humans D007118:Immunoassay D008297:Male D008875:Middle Aged D015676:Osteonectin D058729:Peripheral Arterial Disease D011320:Primary Health Care D063177:Pulse Wave Analysis D015203:Reproducibility of Results D012846:Singapore D015854:Up-Regulation D059289:Vascular Stiffness
SPARC Type 2 diabetes Aortic stiffness Peripheral arterial disease Chronic kidney disease Angiogenesis