Serum calcification propensity is associated with HbA1c in type 2 diabetes mellitus

Introduction Serum calcification propensity is emerging as an independent predictor for cardiovascular outcomes in high-risk populations. Calcification propensity can be monitored by the maturation time of calciprotein particles in serum (T-50 test). A low T-50 value is an independent determinant of cardiovascular morbidity and mortality in various populations. Aim was to investigate the T-50 and its relationship to type 2 diabetes mellitus. Research design and methods Using nephelometry, serum T-50 was cross-sectionally measured in 932 stable patients with type 2 diabetes mellitus (55% male) with a median age of 66 (62-75) years, diabetes duration of 6.5 (3.0-10.2) years and hemoglobin A1c (HbA1c) of 49 (44-54) mmol/mol. Results Serum T-50 was normally distributed with a mean value of 261 +/- 66 min. In linear regression, serum T-50 was lower in women and current smokers. A lower T-50 value was found in patients with a higher HbA1c or higher systolic blood pressure, insulin users and patients with a longer history of diabetes. The association with HbA1c was independent of other determinants in multivariable analysis. There was no association between T-50 and previous macrovascular events or the presence of microvascular disease. Conclusions Serum calcification propensity is independently associated with glycemic control, suggesting that a lower HbA1c may be associated with better cardiovascular outcomes. Retrospective analysis could not establish an association between a history of macrovascular events and T-50, and prospective studies will have to be performed to address this hypothesis.

Automated summary

The study found that in patients with type 2 diabetes, serum T-50 values were closely related to factors such as gender, smoking, blood sugar control, blood pressure, insulin use, and diabetes history, but not related to cardiovascular event history or microvascular disease. This indicates that serum calcification propensity is independently associated with glycemic control in diabetic patients, suggesting that lower HbA1c levels may be associated with better cardiovascular outcomes. Prospective studies are needed to further investigate the relationship between T-50 and a history of macrovascular events.