Abstract 14502: Soluble Vascular Endothelial Growth Factor Receptor-2 as a Predictor of the New Onset of Diabetes Following Smoking Cessation
Background: Although smoking cessation (SC) rapidly decreases the risk of cardiovascular events, it is also associated with the development of diabetes. However, biomarkers which predict the new onset of diabetes following SC are unknown. Recently, we demonstrated that soluble vascular endothelial growth factor (VEGF) receptor-2 (sVEGFR-2), an endogenous inhibitor of VEGF, is increased in sera from patients with metabolic syndrome in association with insulin resistance.
Methods and Results: To examine the predictive value of sVEGFR-2 for the new onset of diabetes, we performed a prospective cohort study involving 168 consecutive, non-diabetic patients who visited the Smoking Cessation Clinic and succeeded in SC. The body mass index (BMI), waist circumference (WC), and serum levels of high-sensitivity C-reactive protein (hsCRP), leptin, adiponectin, VEGF, and sVEGFR-2 were measured at the start and end of the standard 3-month SC program. Patients were divided into two groups by the median at the baseline or by the percentage change in each biomarker. During the median follow-up of 9.5 months, a total of 10 patients developed diabetes (6%). At the baseline, a low adiponectin value was significantly associated with the new onset of diabetes, while other biomarkers, a high BMI (>=25 kg/m2), or high WC (by Japanese criteria) were not. In contrast, a decrease in adiponectin during SC, as well as changes in hsCRP, leptin, VEGF, and BMI, was not significantly associated with the development of diabetes. However, an increase in sVEGFR-2 and that in WC predicted all patients who developed diabetes. To examine an incremental predictive value of sVEGFR-2 over other markers, we performed receiver operating characteristic curve analyses for the new onset of diabetes. The area under the curves (AUCs) of the baseline adiponectin level, the percentage change in WC, and that in sVEGFR-2 were 0.61, 0.71, and 0.74, respectively. Even when smoking-related parameters were included, the combination of these 3 markers and the Brinkman index most markedly increased the AUC (0.82).
Conclusions: An increase in serum sVEGFR-2 levels, as well as the baseline adiponectin level and an increase in WC, may serve as a predictor of the new onset of diabetes following SC.
- © 2013 by American Heart Association, Inc.