Correlation of atherosclerotic markers with type 2 diabetes mellitus and obesity: A cross-sectional analytical study

Background: Type-2 diabetes mellitus (T2DM) patients are at risk of cardiovascular diseases (CVDs) despite many years of treatment, especially those individuals associated with obesity. Oxidized low-density lipoprotein (ox-LDL) triggers a cascade of events that contribute to the formation of atherosclerotic plaques. Regulator of calcineurin (RCAN1) is an emerging marker identified in tissue culture studies which regulates tissue uptake of ox-LDL and is influenced by vascular endothelial growth factor (VEGF)-vascular endothelial growth factor receptor 2 (VEGFR2) signaling. However, no human studies of RCAN1 have been reported. Aims and Objectives: The current study was designed to explore the atherosclerotic markers (RCAN1, ox-LDL, VEGF, and VEGFR2) in high and normal body mass index-diabetes mellitus (BMI-DM) groups and assess their link with body composition parameters. Materials and Methods: T2DM patients on similar metformin-glimepiride treatment regimen were divided into two groups, one with normal BMI (18.5–22.9 kg/m2) and other with high BMI (>23 kg/m2) groups. Controls were healthy participants with age and gender matched similar to Group 1 and Group 2. Fasting blood glucose and lipid profiles were estimated in an autoanalyzer. Serum RCAN1, VEGF, and VEGFR2 were measured by enzyme-linked immunosorbent assay. Body composition was digitally recorded. Comparison was done by one-way analysis of variance. Results: The serum levels of RCAN1, VEGF, and VEGFR2 were significantly increased while ox-LDL was decreased in the high BMI diabetic group. A positive correlation was observed between RCAN1 and ox-LDL (r=0.423; P=0.001). Free fat mass index was significantly decreased, whereas waist–hip ratio (WHR) was found to be higher in the normal BMI-DM group. A significant increase in body fat mass index and WHR was noticed in the high BMI-DM group. Conclusion: Thus, based on the findings of the current study, it may be suggested that the different risk profile for CVD in T2DM individuals despite several years of treatment may be linked to the difference in not only BMI but also the type of fat distribution, body composition, and type of diet.