Background: Silent coronary artery disease is a frequent complication of type 2 diabetes (T2DM). Based on its multiple roles in inflammation, atherogenesis and glucose homeostasis, we hypothesised that activin A could be related to coronary atherosclerosis in T2DM.
Methods: Activin A and follistatin were measured in 102 patients with T2DM and 20 age- and sex-matched healthy controls. Coronary angiography was performed in a sub-population of patients and associations with activin A were examined using multiple linear regression.
Results: Serum activin A and the activin A/follistatin ratio were increased in patients with T2DM and coronary artery disease (CAD) compared with healthy volunteers and the elevated activin A was associated with the severity of coronary atherosclerotic burden as determined by the proportion of ≥2 vessel disease (p = 0.035) after multivariable-adjusted trend analysis. No significant association between presence of CAD or extent score and activin A was observed.
Conclusion: In patients with T2DM, increased activin A may reflect chronic underlying pathophysiological processes involved in development of cardiovascular disease.