Galectin-3, metalloproteinase-2 and cardiovascular disease were independently associated with metalloproteinase-14 in patients with type 1 diabetes: a cross sectional study

BACKGROUND Type 1 diabetes (T1D) is a major risk factor for cardiovascular disease (CVD). Matrix metalloproteinase-14 (MMP-14) is involved in the development of atherosclerosis and CVD. The main aim was to explore the associations between MMP-14 and selected inflammatory and metabolic variables, CVD, depression, physical activity, smoking and medication in patients with T1D. The secondary aim was to explore associations with CVD. METHODS Cross-sectional design. The participants were consecutively recruited from one specialist diabetes out-patient clinic. Depression was assessed by a self-report instrument. Blood samples, anthropometrics and blood pressure were collected, supplemented with data from electronic health records. High MMP-14 was defined as  ≥  5.81 ng/mL. Non-parametric tests, Chi2 tests and multiple logistic regression analyses were performed. RESULTS Two hundred and sixty-eighth T1D patients aged 18-59 years participated (men 58%, high MMP-14 25%, CVD 3%). Sixty-seven patients with high MMP-14, compared to 201 patients with lower MMP-14, had higher prevalence of CVD (8% versus 1%, p  =  0.012), and had higher levels of galectin-3 (p  <  0.001) and MMP-2 (p  =  0.018). Seven patients with CVD, compared to 261 without, were older (p  =  0.003), had longer diabetes duration (p  =  0.027), and had higher prevalence of high MMP-14 (71% versus 24%, p  =  0.012), abdominal obesity (p  =  0.014), depression (p  =  0.022), usage of antidepressants (p  =  0.008), antihypertensive drugs (p  =  0.037) and statins (p  =  0.049). Galectin-3 (per ng/mL) [adjusted odds ratio (AOR) 2.19, p  <  0.001], CVD (AOR 8.1, p  =  0.027), and MMP-2 (per ng/mL) (AOR 1.01, p  =  0.044) were associated with high MMP-14. Depression (AOR 17.4, p  =  0.006), abdominal obesity (15.8, p  =  0.006), high MMP-14 (AOR 14.2, p  =  0.008), and diabetes duration (AOR 1.10, p  =  0.012) were associated with CVD. CONCLUSIONS The main findings of this study were that galecin-3, MMP-2, and CVD were independently associated with high levels of MMP-14 in T1D patients. The association between MMP-14 and galectin-3 is a new finding. No traditional risk factors for CVD were associated with MMP-14. Depression, abdominal obesity and MMP-14 were independently associated with CVD.