Comparison of non-traditional biomarkers, and combinations of biomarkers, for vascular risk prediction in people with type 2 diabetes: The Edinburgh Type 2 Diabetes Study

Price, A. H., Weir, C. J., Welsh, P. , McLachlan, S., Strachan, M. W.J., Sattar, N. and Price, J. F. (2017) Comparison of non-traditional biomarkers, and combinations of biomarkers, for vascular risk prediction in people with type 2 diabetes: The Edinburgh Type 2 Diabetes Study. Atherosclerosis, 264, pp. 67-73. (doi: 10.1016/j.atherosclerosis.2017.07.009) (PMID:28777936) (PMCID:PMC5603967)

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Abstract

We aimed at comparing the impact of multiple non-traditional biomarkers (ankle brachial pressure index (ABI), N-terminal pro-brain natriuretic peptide (NT-proBNP), high sensitivity cardiac troponin (hs-cTnT), gamma-glutamyl transpeptidase (GGT) and four markers of systemic inflammation), both individually and in combination, on cardiovascular risk prediction, over and above traditional risk factors incorporated in the QRISK2 score, in older people with type 2 diabetes. We conducted a prospective study of 1066 men and women aged 60-75 years with type 2 diabetes mellitus, living in Lothian, Scotland. After 8 years, 205 cardiovascular events occurred. Higher levels of hs-cTNT and NT-proBNP and lower ABI at baseline were associated with increased risk of CV events, independently of traditional risk factors (basic model). The C statistic of 0.722 (95% CI 0.681, 0.763) for the basic model increased on addition of individual biomarkers, most markedly for hs-cTnT (0.732; 0.690, 0.774)). Models including different combinations of biomarkers had even greater C statistics, with the highest for ABI, hs-cTnT and GGT combined (0.740; 0.699, 0.781). Individually, hs-cTnT appeared to be the most promising biomarker in terms of improving vascular risk prediction in people with type 2 diabetes, over and above traditional risk factors incorporated in the QRISK2 score. Combining several non-traditional biomarkers added further predictive value, and this approach merits further investigation when developing cost effective risk prediction tools for use in clinical practice.

Item Type:Articles
Keywords:Biomarkers, cardiovascular disease, epidemiology, risk prediction, type 2 diabetes.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Welsh, Dr Paul and Sattar, Professor Naveed
Authors: Price, A. H., Weir, C. J., Welsh, P., McLachlan, S., Strachan, M. W.J., Sattar, N., and Price, J. F.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
Journal Name:Atherosclerosis
Publisher:Elsevier
ISSN:0021-9150
ISSN (Online):1879-1484
Published Online:12 July 2017
Copyright Holders:Copyright © 2017 Elsevier Ireland Ltd.
First Published:First published in Atherosclerosis 264:67-73
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
501161Inflammation, glucocorticoids and microvascular disease in the aetiology of cognitive impairment in type 2 diabetesGordon LoweMedical Research Council (MRC)G0500877SCHOOL OF MEDICINE, DENTISTRY & NURSING
690421Glasgow Molecular Pathology (GMP) NodeKarin OienMedical Research Council (MRC)MR/N005813/1ICS - EXPERIMENTAL THERAPEUTICS