Associations between autoantibodies against apolipoprotein B-100 peptides and vascular complications in patients with type 2 diabetes

Diabetologia. 2009 Jul;52(7):1426-33. doi: 10.1007/s00125-009-1377-9. Epub 2009 May 12.


Aims/hypothesis: Oxidation of LDL in the arterial extracellular matrix is a key event in the development of atherosclerosis and autoantibodies against oxidised LDL antigens reflect disease severity and the risk of developing acute cardiovascular events. Since type 2 diabetes is associated with increased oxidative stress, we tested the hypothesis that autoantibodies against oxidised LDL antigens are biomarkers for vascular complications in diabetes.

Methods: We studied 497 patients with type 2 diabetes without clinical signs of coronary heart disease. Oxidised LDL autoantibodies were determined by ELISA detecting IgG and IgM specific for native and malondialdehyde (MDA)-modified apolipoprotein B-100 peptides p45 and p210. The severity of coronary disease was assessed as the coronary artery calcium score.

Results: Patients affected by retinopathy had significantly higher levels of IgG against MDA-p45 and MDA-p210. In contrast, high levels of autoantibodies against the corresponding native peptides were associated with less coronary calcification and a lower risk of progression of coronary disease.

Conclusions/interpretation: Our observations suggest that LDL oxidation is involved in the pathogenesis of diabetic retinopathy and that autoantibodies against apolipoprotein B peptides may act as biomarkers for both micro- and macrovascular complications in diabetes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Albuminuria / epidemiology
  • Albuminuria / immunology
  • Apolipoprotein B-100 / immunology*
  • Autoantibodies / blood*
  • Biomarkers / blood
  • Coronary Disease / epidemiology
  • Coronary Disease / immunology
  • Diabetes Complications / epidemiology*
  • Diabetes Complications / immunology*
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Diabetes Mellitus, Type 2 / immunology*
  • Diabetic Angiopathies / epidemiology
  • Diabetic Angiopathies / immunology
  • Diabetic Nephropathies / epidemiology
  • Diabetic Nephropathies / immunology
  • Diabetic Retinopathy / epidemiology
  • Diabetic Retinopathy / immunology
  • Female
  • Humans
  • Immunoglobulin G / blood
  • Lipoproteins, LDL / immunology
  • Male
  • Microcirculation / immunology
  • Middle Aged
  • Risk Factors


  • Apolipoprotein B-100
  • Autoantibodies
  • Biomarkers
  • Immunoglobulin G
  • Lipoproteins, LDL
  • oxidized low density lipoprotein