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Association between renin and atherosclerotic burden in subjects with and without type 2 diabetes

  • Isabel Gonçalves
  • Andreas Edsfeldt
  • Helen M. Colhoun
  • Angela C. Shore
  • Carlo Palombo
  • Andrea Natali
  • Gunilla Nordin Fredrikson
  • Harry Björkbacka
  • Maria Wigren
  • Eva Bengtsson
  • Gerd Östling
  • Kunihiko Aizawa
  • Francesco Casanova
  • Margaretha Persson
  • Kim Gooding
  • Phil Gates
  • Faisel Khan
  • Helen C. Looker
  • Fiona Adams
  • Jill Belch
  • Silvia Pinnola
  • Elena Venturi
  • Michaela Kozakova
  • Li Ming Gan
  • Volker Schnecke
  • Jan Nilsson
Publishing year: 2016-09-05
Language: English
Pages: 1-10
Publication/Series: BMC Cardiovascular Disorders
Volume: 16
Issue: 1
Document type: Journal article
Publisher: BioMed Central

Abstract english

Background: Activation of the renin-angiotensin-aldosterone-system (RAAS) has been proposed to contribute to development of vascular complications in type 2 diabetes (T2D). The aim of the present study was to determine if plasma renin levels are associated with the severity of vascular changes in subjects with and without T2D. Methods: Renin was analyzed by the Proximity Extension Assay in subjects with (n = 985) and without (n = 515) T2D participating in the SUMMIT (SUrrogate markers for Micro- and Macro-vascular hard endpoints for Innovative diabetes Tools) study and in 205 carotid endarterectomy patients. Vascular changes were assessed by determining ankle-brachial pressure index (ABPI), carotid intima-media thickness (IMT), carotid plaque area, pulse wave velocity (PWV) and the reactivity hyperemia index (RHI). Results: Plasma renin was elevated in subjects with T2D and demonstrated risk factor-independent association with prevalent cardiovascular disease both in subjects with and without T2D. Renin levels increased with age, body mass index, HbA1c and correlated inversely with HDL. Subjects with T2D had more severe carotid disease, increased arterial stiffness, and impaired endothelial function. Risk factor-independent associations between renin and APBI, bulb IMT, carotid plaque area were observed in both T2D and non-T2D subjects. These associations were independent of treatment with RAAS inhibitors. Only weak associations existed between plasma renin and the expression of pro-inflammatory and fibrous components in plaques from 205 endarterectomy patients. Conclusions: Our findings provide clinical evidence for associations between systemic RAAS activation and atherosclerotic burden and suggest that this association is of particular importance in T2D.


  • Cardiac and Cardiovascular Systems
  • Arterial stiffness
  • Atherosclerosis
  • Endothelial dysfunction
  • Renin
  • Type 2 diabetes


  • Cardiovascular Research - Immunity and Athersosclerosis
  • ISSN: 1471-2261

Lund University Diabetes Centre, CRC, SUS Malmö, Jan Waldenströms gata 35, House 91:12. SE-214 28 Malmö. Telephone: +46 40 39 10 00