ls0 ws1">insulin- dependent diabe t es [8].
For the last decade, we have documented a defined
association of IgA anti-beta2-gpI antibodies with cere-
bral ischemia [9], coronary disease [10], carotid disease
[11], and peripheral artery disease [12]. Only in one of
these studies [12], IgA ACA associated with the outcome.
More recently, we demonstrated an association of the
IgA anti-beta2-gpI antibody with metabolic syndrome;
once more, the ACA prevalence was low [13]. We there-
fore infer that ACA do not relate to acute or chronic
atherosclerotic disease, nor to metabolic syndrome. The
relationship of ACA with type 2 diabetes and diabetic
vasculopathy had not been so far evaluated in our re-
search center.
In the current study, ACA positivity was similar in
controls and type 2 diabetics (7.4% and 9.5%, respec-
tively). There was no statistical difference as to the ACA
prevalence in the two groups. The frequency of IgA ACA
in our healthy co ntrols (5.6%) was quite impressive, and
this is an issue to be further addressed. Differently from
our data, Hendra et al reported a significant frequency of
IgG ACA in diabetics with or without coronary disease
[14]. Gargiulo et al. described elevated levels of IgA
anti-phosphatidylethanolamine, but not ACA, in type 1
or 2 diabetics as compared to controls [15]. Similarly to
our findings, the prevalence of ACA in non-complicated
diabetes was irrelevant in another previous study [16].
When our two groups of diabetics were compared, a
weak association of IgM ACA with complicated diabetes
was suggested by the adjusted OR, but this finding was
statistically insignificant. Of interest, the frequency of
ACA in type 1 or 2 diabetics with macroangiopathy and
nephropathy was higher as compared to patients with
non-complicated or well-controlled disease [16]. Another
group of authors reported, in 1989, an increased positi-
vity for IgG and IgA ACA in type 2 diabetics with
macrovascular disease [17]. As seen, data concerning
prevalence of ACA in diabetes are incongruent.
We herein documented a significant correlation of IgG
and IgM ACA with increasing age. This is in accordance
with the study by Fields et al., whereby IgG and IgM
ACA were detected in 12% of the healthy elderly and in
2% of younger adults [18]. As opposed to that, ACA
positivity in the elderly was reported to be insignificant
and similar to younger populations [19].
In general terms, our results pointed to a insignificant
positivity for ACA in type 2 diabetes. A low prevalence
of ACA was seen in both complicated or non-compli-
cated diabetic populations. These data, although limited
by the small sample, do not favour a pathogenetic role
for ACA in type 2 diabetes and diabetic macrovasculo-
pathy. Our findings are corroborated by those reported by
Tarkun et al., which desvinculated ACA from vascular
complications of type 2 diabetes [20].
In summary, the frequency of a positive ACA test in
type 2 diabetes (complicated or not by macrovasculo-
Table 1. Clinical variables and frequency of anticardiolipin antibodies (ACA) in both group of diabetics.
Diabetics with
vascular event n = 33 Diabetics without
vascular event n = 40 p Non-adjusted OR
(95% CI) Adjusted OR***
(95% CI) p
Age (years) 68.2 (±10.65) 65.9 (±9.1) 0.331 1.0 (0.9 - 1.1) NC NC
Females 16 (48.5%) 33 (82.5%) 0.005* 0.2 (0.1 - 0.6) NC NC
Hypertension 29 (87.9%) 33 (82.5%) 0.744* 1.5 (0.4 - 5.8) NC NC
History of smoking 8 (24.2%) 11 (27.5%) 0.962* 0.8 (0.3 - 2 .4) NC NC
IgG ACA positive 0 1 (2.5%) 0.999* 0.6 (0.05 - 6.8)** NC NC
IgM ACA positive 3 (9.1%) 1 (2.5%) 0.475* 3.9 (0.4 - 39.4) 2.7 (0.2 - 34.2) 0.441
IgA ACA positive 0 2 (5.0%) 0.560* 0.4 (0.04 - 3.9)** NC NC
n: Sample number; SD: Standard deviation; Student t test; *Chi-square test; **Agresti correction; ***Adjustment for sex, age, hypertension and smoking; NC:
on-calculated. N
Copyright © 2012 SciRes. OPEN ACCESS
C. E. Copetti et al. / Open Journal of Internal Medicine 2 (2012) 37-39 39
pathy) did not significantly differ from controls. There
was no association of ACA with vascular events in
patients with type 2 diabetes. ACA do not appear to be
relevant in the pathogenesis of vascular complications of
type 2 diabetes.
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