VASCULAR COMPLICATIONS OF DIABETES-MELLITUS - WHAT ROLE FOR PHOSPHOLIPID-BINDING ANTIBODIES

Vascular complications are the main cause of morbidity in diabetes mel litus. However, the risk factors for vascular disease remain uncomplet ely elucidated. It has been previously suggested that factors other th an glycemia may contribute to the development of vasculopathy. In this study we determined the prevalence of phospholipid-binding antibodies in uncomplicated and complicated diabetes. We studied 53 uncomplicate d diabetic patients, with type 1 (n = 32) or type 2 (n = 21) diabetes; 23 diabetic patients with proliferative retinopathy; 28 diabetic pati ents with an overt nephropathy; 37 diabetic patients with macroangiopa thy and 22 non diabetic control patients. Both lupus anticoagulant and anticardiolipin antibodies were determined. Other risk factors for ma croangiopathy were analysed. The prevalence of phospholipid-binding an tibodies was similar in uncomplicated diabetic patients and in control s (type 1 diabetes: 9.4%; type 2 diabetes: 9.5%; control group: 4.6%; P = 0.76). In complicated diabetes, the frequency of these antibodies was increased only in patients with overt nephropathy (32.1%, P=0.01) or with macroangiopathy (32.4%, P=0.01) while patients with isolated r etinopathy were comparable with uncomplicated diabetic patients (4.3%, P=0.66). Uncomplicated diabetes was not associated with phospholipid- binding antibodies. We found a higher prevalence of these antibodies i n diabetic patients with macroangiopathy or nephropathy. These results suggest a potential role of phospholipid-binding antibodies in the pr ogression of vascular complications in diabetes mellitus.