Markers and Mechanisms of Vascular Disease in Type II Diabetes
OBJECTIVES: Vascular Disease is the leading cause of complications and death in patients with diabetes. Risk markers and underlying mechanisms have not been fully elucidated, and may differ from those in non-diabetic individuals. The unifying theme for the Program Project is that hyperglycemia and insulin resistance alter a number of biological processes which interact in vicious cycles to accelerate atherogenesis and are consequently major underlying risk factors for vascular disease. The overall objectives are to define these unique processes and to elucidate underlying biochemical, metabolic, and genetic determinants of vascular disease complications in diabetes.
RESEARCH PLAN: Over the past 4 years, we have collaborated with the DCCT/EDIC Study Group, and have made novel observations regarding vascular disease pathogenesis in Type 1 Diabetes. This work has focused our studies on specific pathogenic processes. We will now study a Type 2 Diabetes cohort from the VA Cooperative Study, "Glycemic Control and the Complications of Diabetes, Type 2", with high vascular disease event rates. These collaborations provide a unique opportunity to address the pathogenesis of accelerated atherogenesis in the two main types of diabetes, and will greatly augment the scientific knowledge that will be gained in the conduct of these world-class prospective trials.
METHODS: The Program Project has 4 projects and 3 cores. Project 1 will assess lipoproteins, glycoxidative stress, and inflammation as risk factors in studies involving Type 2 Diabetes patients and cultured cell systems. Based on preliminary data from our initial studies Type 1 patients, changes in the NMR lipoprotein subclass profile will be emphasized.
Project 2 will elucidate interactions between inflammation, modifications of lipoproteins, and autoimmunity in vascular disease risk. These novel concepts are also based upon exciting preliminary data pertaining to LDL-antibody complexes.
Project 3 will pursue interesting preliminary data and define the role of the kallikrein-kinin system in vascular disease complications, with effects on mitogenesis and matrix production.
Project 4 will assess the role of the Insulin Resistance Syndrome and novel factors secreted from adipocytes in the pathophysiology of biochemical risk factors and cardiovascular complications.
Cores include an Administrative Core, a Biostatistics and Epidemiology Core which will link with the trials data coordinating centers, and Molecular and Statistical Genetics Core. Investigators will work in close collaboration with the VA Executive Committee, Study Centers, the Hines Coordinating Center, and some of the other ancillary studies. All data analysis involving clinical outcomes will be performed at the Hines Coordinating Center.
There is true synergism among the projects at both scientific and logistical levels. The Program Project design allows for interactions among multidisciplinary investigators studying the same cohort, which will define how multiple pathological processes interact at the level of the arterial wall to promote atherosclerosis.
|Study Design:||Observational Model: Cohort|
|Official Title:||CSP #465D - Markers And Mechanisms of Vascular Disease in Type II Diabetes|
- The primary outcome measure is to define these unique processes and to elucidate underlying biochemical, metabolic, and genetic determinants of vascular disease complications in diabetes. [ Time Frame: 2, 4, and 6 years. ]
Biospecimen Retention: Samples Without DNA
|Study Start Date:||June 2007|
|Study Completion Date:||May 2008|
|Primary Completion Date:||May 2008 (Final data collection date for primary outcome measure)|
Patients who are enrolled in the ongoing randomized clinical trial AGlycemic Control and Complications in Diabetes Mellitus Type 2".
ROSIGLITAZONE (roe si GLI ta zone) helps to treat type 2 diabetes. It helps to control blood sugar. Treatment is combined with diet and exercise.
Show Detailed Description
Please refer to this study by its ClinicalTrials.gov identifier: NCT00256646
|United States, Arizona|
|Carl T. Hayden VA Medical Center|
|Phoenix, Arizona, United States, 85012|
|Southern Arizona VA Health Care System, Tucson|
|Tucson, Arizona, United States, 85723|
|United States, California|
|VA Central California Health Care System, Fresno|
|Fresno, California, United States, 93703|
|VA Medical Center, Long Beach|
|Long Beach, California, United States, 90822|
|VA San Diego Healthcare System, San Diego|
|San Diego, California, United States, 92161|
|United States, Florida|
|Miami VA Healthcare System, Miami, FL|
|Miami, Florida, United States, 33125|
|United States, Illinois|
|Edward Hines, Jr. VA Hospital|
|Hines, Illinois, United States, 60141-5000|
|United States, Indiana|
|Richard Roudebush VA Medical Center, Indianapolis|
|Indianapolis, Indiana, United States, 46202-2884|
|United States, Kentucky|
|VA Medical Center, Lexington|
|Lexington, Kentucky, United States, 40502|
|United States, Minnesota|
|VA Medical Center, Minneapolis|
|Minneapolis, Minnesota, United States, 55417|
|United States, Nebraska|
|VA Medical Center, Omaha|
|Omaha, Nebraska, United States, 68105-1873|
|United States, New Jersey|
|VA New Jersey Health Care System, East Orange|
|East Orange, New Jersey, United States, 07018|
|United States, Pennsylvania|
|VA Pittsburgh Health Care System|
|Pittsburgh, Pennsylvania, United States, 15240|
|United States, Texas|
|Michael E. DeBakey VA Medical Center (152)|
|Houston, Texas, United States, 77030|
|VA South Texas Health Care System, San Antonio|
|San Antonio, Texas, United States, 78229|
|United States, Virginia|
|VA Medical Center, Salem VA|
|Salem, Virginia, United States, 24153|
|VA Medical Center, San Juan|
|San Juan, Puerto Rico, 00921|
|Study Chair:||Carlos Abraira, MD||Miami VA Healthcare System, Miami, FL|