Association of soluble CD40 ligand with carotid atherosclerosis in Japanese type 1 diabetic patients

Aims/hypothesis: It has recently been shown that the soluble form of CD40 ligand (sCD40L) interacts with CD40 on vascular cells, leading to a variety of proinflammatory responses, and that serum sCD40L levels can be a predictive marker of cardiovascular events. The aim of this study was to estimate sCD40L levels in type 1 diabetic patients to examine a possible association with carotid atherosclerosis. Subjects and methods: Human sCD40L levels in serum and intima-media thickness (IMT) of carotid artery were examined in 80 Japanese type 1 diabetic patients (27 men and 53 women, age 22.8 +/- 3.4 years (mean +/- SD), duration of diabetes 13.2 +/- 6.1 years) and 20 healthy age-matched non-diabetic individuals. Results: Serum sCD40L levels were significantly (p=0.0185) higher in subjects with type 1 diabetes (2.10 +/- 1.33 ng/ml) compared with non-diabetic subjects (1.35 +/- 0.88 ng/ml). The greatest IMT (Max-IMT) and averaged IMT (Mean-IMT) were also significantly greater in patients with type 1 diabetes than in control subjects (0.73 +/- 0.14 vs 0.64 +/- 0.07 mm, p=0.0041, 0.63 +/- 0.09 vs 0.57 +/- 0.06 mm, p=0.0066, respectively). Levels of sCD40L were statistically significantly associated with Max-IMT (r=0.383, p < 0.001) and Mean-IMT (r=0.275, p=0.0058). Furthermore, stepwise multivariate regression analyses demonstrated that sCD40L is a determinant of both Max- and Mean-IMT, independently of conventional risk factors. Conclusions/interpretation: It is suggested that increased levels of serum sCD40L are associated with accelerated atherosclerotic change observed in young patients with type 1 diabetes.