In conclusion, the deficiency of ADAMTS13 may underlie the onset of lethal arrhythmias in diabetes through increased CaMKII phosphorylation in cardiomyocytes.
In contrast, low ADAMTS13 was associated with increased risk of dementia throughout follow-up (hazard ratio per SD decrease- 1.16 [1.06-1.28]), which alike for ischaemic stroke, was modified by the presence of diabetes (P-interaction = 0.003).
Genetically predicted ADAMTS-13 activity, based on three genetic variants, was consistently inversely associated with IHD (IVW odds ratio [OR] 0.91 per effect size; 95% confidence interval [CI] 0.86-0.97) but not with diabetes (OR 0.94, 95% CI 0.88-1.01) or high or low-density lipoprotein cholesterol (0.01, 95% CI -0.02 to 0.04; -0.01, 95% CI -0.04 to 0.02, respectively).
Moreover, VWF and ADAMTS13 have been recently proposed as prognostic biomarkers in cardiovascular, metabolic, and inflammatory diseases, such as diabetes, stroke, myocardial infarction, and sepsis.
Although ADAMTS13 activity was positively associated with fasting glucose and insulin, the association with incident diabetes did not change when we adjusted for these covariates.