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The Egyptian Journal of Internal Medicine
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Cyclophilin A: a novel biomarker for cardiovascular disease in patients with type 2 diabetes

The Egyptian Journal of Internal Medicine volume 31, pages 416–422 (2019)Cite this article

Abstract

Background and aims

Type 2 diabetes mellitus (DM) is a strong independent risk factor for coronary heart disease. Cyclophilin A (CyPA) is a protein secreted from vascular smooth muscle cells in response to reactive oxygen species. It is suggested that CyPA plays an important role in later stages of atherosclerosis and plaque rupture. It was demonstrated that plasma levels of CyPA are significantly higher in patients with coronary artery disease (CAD) in proportion to severity of disorder. Moreover, several studies have demonstrated a role of CyPA as a biomarker of CADs. Indeed studies revealed significantly higher plasma levels of CyPA in patients with CAD with type 2 DM.

Objective

To assess the severity of CAD among diabetic and prediabetic patients and predict future cardiovascular events.

Patients and methods

The study was conducted on 65 patients with CAD diagnosed by coronary angiography, stratified according to GRACE score into low/intermediate/high death risk categories and subdivided into diabetic, prediabetic, and nondiabetic, and 20 age-matched and sex-matched patients, who had normal angiography as a control group. Blood samples were collected for determination of glycated hemoglobin (HbA1c), serum creatinine, cardiac troponin, and CyPA level using double-antibody sandwich enzyme-linked immunosorbent assay technique.

Results

There were significantly higher levels of CyPA among patient group than control group (P<0.001). Moreover, significantly higher CyPA levels were detected in diabetic group when compared with normal and prediabetic groups (P<0.029). CyPA was positively correlated with HbA1c in all patients and with diabetic patients. HbA1c was negatively correlated with serum creatinine and positively with estimated glomerular filtration rate in prediabetic group and with systolic blood pressure in diabetic group. The number of occluded vessels was positively correlated with both CyPA and HbA1c. The diagnostic sensitivity and specificity of CyPA were 76.92 and 95%, respectively, at a cutoff value of more than 13 ng/ml.

Conclusion

CyPA can be used as an early predictor of CAD in patients with type 2 DM and also in prediabetic patients.

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Authors and Affiliations

  1. Department of Clinical Pathology, Ain Shams University, Cairo, Egypt

    Manal M. Hussain

  2. Department of Internal Medicine, Ain Shams University, 10 Ahmed Saman St. Infront of Serag Mall, Nasr City, Cairo, 1199, Egypt

    Emad A. M. Abdel Hady Mohammed MBBCH, MSc, PhD (Ass. Professor of Internal Medicine), Alyaa A. El-Sherbeny & Amira R. Shehata

Authors
  1. Manal M. Hussain
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  2. Emad A. M. Abdel Hady Mohammed MBBCH, MSc, PhD
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  3. Alyaa A. El-Sherbeny
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  4. Amira R. Shehata
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Corresponding author

Correspondence to Emad A. M. Abdel Hady Mohammed MBBCH, MSc, PhD.

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Hussain, M.M., Abdel Hady Mohammed, E.A.M., El-Sherbeny, A.A. et al. Cyclophilin A: a novel biomarker for cardiovascular disease in patients with type 2 diabetes. Egypt J Intern Med 31, 416–422 (2019). https://doi.org/10.4103/ejim.ejim_147_19

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  • DOI: https://doi.org/10.4103/ejim.ejim_147_19

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