An international academic consortium has identified 13 biomarkers that significantly improve the ability to accurately predict cardiovascular disease risk in people with type 2 diabetes. The analysis, conducted by 23 experts from 11 countries, was conducted by Johns Hopkins University in the US, the Chinese University of Hong Kong and Lund University in Sweden.
Although people with type 2 diabetes are twice as likely to develop cardiovascular disease as people without diabetes, predicting who is most at risk in this population is a challenge for clinicians. Traditional risk scores, which reflect the level of risk in the presence of certain risk factors, are dated and do not work well in different populations.
More than 500 million people worldwide live with diabetes. With the high numbers, it is important to identify accessible ways to accurately classify patients so that those at high risk of cardiovascular disease can receive the preventive care they need.”
Maria F. Gómez, PhD, co-senior author of the analysis, research group leader at Lund University Diabetes Center and professor of physiology at Lund University.
With this in mind, the research team reviewed and analyzed medical studies published since the 1990s that investigated differences between people with type 2 diabetes who experienced cardiovascular disease and those who did not.
“Our goal was to identify promising markers that could improve cardiovascular risk prediction in people with type 2 diabetes,” said Nestoras Mathioudakis, MD, MHS, co-senior author of the analysis, co-medical director of the Johns Hopkins Medicine Diabetes Prevention and Education Program, and is an associate professor of medicine at the Johns Hopkins University School of Medicine. “We wanted to look beyond traditional prognostic factors such as hypertension and smoking.”
From their review and analysis of published medical literature, the team extracted data on 321 biomarkers and found that 13 were significantly associated with cardiovascular risk in people with type 2 diabetes. The standout biomarker was N-terminal pro B-type natriuretic peptide (nt-proBNP), which is currently used to monitor heart failure status in patients. The team found that, in several studies, higher levels of NT-proBNP in the body were associated with a higher risk of cardiovascular disease. A study of 16,000 patients that the team reviewed found a 64% increased risk for every standard deviation increase in NT-proBNP.
“The 13 biomarkers, especially NT-proBNP, warrant further testing to evaluate their potential,” said Ronald Ma, MBBChir., FRCP, FHKCP, FHKAM, co-senior author of the analysis and SH Ho, professor of diabetes at the Chinese University of Hong Kong. “If future studies confirm their value in predicting cardiovascular risk in patients with type 2 diabetes, we may be able to change the standard of care.”
The study was conducted as part of the Precision Medicine in Diabetes Initiative, an international partnership between the American Diabetes Association and the European Association for the Study of Diabetes.
The analysis was published in January. 22 inches Communication Medicine.
Ahmed, A., etc (2024). Accurate prediction of cardiovascular disease in type 2 diabetes: a systematic review and meta-analysis. Communication Medicine. doi.org/10.1038/s43856-023-00429-z.