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Open Access Open Badges Original investigation

The relationship between serum hypoxia-inducible factor 1α and coronary artery calcification in asymptomatic type 2 diabetic patients

Gang Li1*, Wei-hua Lu1, Rong Ai2, Jian-hong Yang1, Fang Chen3 and Zhong-zhi Tang1

Author Affiliations

1 Emergency Department, Wuhan General Hospital of Guangzhou Military Command, Wu Luo Road, Hong Shan, Wuhan, China

2 College of Foreign Language, Huazhong Agriculture University, Hongshan, Wuhan, Hubei 430070, China

3 Department of Medicine Laboratory, Wuhan General Hospital of Guangzhou Military Command, Wuhan, China

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Cardiovascular Diabetology 2014, 13:52  doi:10.1186/1475-2840-13-52

Published: 24 February 2014



Hypoxia-inducible factor 1 (HIF-1), a master regulator of oxygen homeostasis, is a heterodimer consisting of HIF-1α and HIF-1β subunits, and is implicated in calcification of cartilage and vasculature. The goal of this study was to determine the relationship between serum HIF-1α with coronary artery calcification (CAC) in patients with type 2 diabetes.


The subjects were 405 (262 males, 143 females, age 51.3 ± 6.4 years) asymptomatic patients with type 2 diabetes mellitus. Serum HIF-1α and interleukin-6 (IL-6) levels were measured by ELISA. CAC scores were assessed by a 320-slice CT scanner. The subjects were divided into 4 quartiles depending on serum HIF-1α levels.


Average serum HIF-1α was 184.4 ± 66.7 pg/ml. Among patients with higher CAC scores, HIF-1α levels were also significantly increased (p <0.001). HIF-1α levels positively correlated with CRP, IL-6, UKPDS risk score, HbA1c, FBG, and CACS, but did not correlate with diabetes duration, age, and LDL. According to the multivariate analysis, HIF-1α levels significantly and independently predict the presence of CAC. ROC curve analysis showed that the serum HIF-1α level can predict the extent of CAC, but the specificity was lower than the traditional risk factors UKPDS and HbA1c.


As a marker of hypoxia, serum HIF-1α level may be an independent risk factor for the presence of CAC. These findings indicate that elevated serum HIF-1α may be involved in vascular calcification in patients with type 2 diabetes mellitus.

Hypoxia-inducible factor 1α; Coronary artery calcification; Atherosclerosis; Type 2 diabetes mellitus