Diabetes, Metabolic Syndrome and Obesity (Feb 2022)

Angiotensinogen and Risk of Stroke Events in Patients with Type 2 Diabetes Mellitus

  • Liu T,
  • Liu W

Journal volume & issue
Vol. Volume 15
pp. 419 – 425

Abstract

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Tao Liu,1 Weihong Liu2 1Department of Neurology, Tianjin Nankai Hospital, Tianjin, 300100, People’s Republic of China; 2Department of Traditional Chinese Medicine, Tianjin Fourth Central Hospital, Tianjin, 300140, People’s Republic of ChinaCorrespondence: Tao Liu Department of Neurology, Tianjin Nankai Hospital, NO. 6, Changjiang Road, Nankai District, Tianjin, 300100, People’s Republic of China Email [email protected]: Activation of the renin-angiotensin system (RAS) in diabetic patients is a vital pathophysiological mechanism of cardiovascular complications.Aim: We aimed to assess whether serum and urinary angiotensinogen levels could predict the risk of stroke events in patients with type 2 diabetes.Methods: An analysis of the relationships between serum and urinary angiotensinogen levels at baseline and the risk of stroke events was performed in a study consisting of 467 patients with type 2 diabetes with a follow-up of 5 years. Multivariate Cox regression models were built by controlling for a large range of related risk factors.Results: Kaplan–Meier analysis showed that patients with low estimated glomerular filtration rate (eGFR) < 57 mL/min/1.73 m2 had a significantly higher risk of stroke events than those with high eGFRs (≥ 57 mL/min/1.73 m2, P=0.040). Our results suggested that urinary angiotensinogen levels (HR=2.74, 95% CI 1.50– 5.88, P=< 0.001), but not serum angiotensinogen levels (HR=1.42, 95% CI 0.95– 2.65, P=0.071), were independent predictors of the risk of stroke events in patients with type 2 diabetes after adjusting for confounding factors. Similarly, sensitivity analysis also suggested that higher urinary angiotensinogen levels still contributed to an increased risk of stroke events (HR=2.71, 95% CI 1.48– 5.82, P< 0.001) but not serum angiotensinogen levels (HR=1.37, 95% CI 0.89– 2.21, P=0.104). Importantly, we found that significant associations only existed in patients with eGFRs< 60 mL/min/1.73 m2 (HR=2.78, 95% CI 1.59– 6.30, P< 0.001) but not in patients with eGFRs≥ 60 mL/min/1.73 m2 (HR=1.39, 95% CI 0.95– 3.53, P=0.054).Conclusion: The study suggested that elevated urinary angiotensinogen levels were correlated with a higher risk of stroke events in patients with type 2 diabetes mellitus.Keywords: angiotensinogen diabetes mellitus, stroke, Cox proportional hazard regression

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