An analysis conducted by an international research team has identified 13 biomarkers that may improve the accuracy of predicting the risk of cardiovascular disease (CVD) in people with type 2 diabetes.
The study, findings from which have been published in Communications Medicine, was led by researchers from Johns Hopkins University in Baltimore, the Chinese University of Hong Kong, and Lund University in Lund, Sweden.
People with type 2 diabetes are at significant risk of developing CVD; however, predicting the risk for patients presents challenges, and current risk scoring algorithms are of limited value, especially in diverse populations.
The research team analyzed data from 416 studies published from the year 1990 to the present that investigated differences between people with type 2 diabetes with CVD and those without CVD.
From their analysis of the literature, which included data from 321 biomarker studies, 48 genetic marker studies, and 47 risk score/model studies, 13 biomarkers were significantly associated with CVD in people with type 2 diabetes.
The biomarkers that held the most promise for predictive value that the team identified were N-terminal pro B-type natriuretic peptide (NT-proBNP), troponin-T (TnT), triglyceride-glucose (TyG), and the genetic risk score for coronary heart disease (GRS-CHD), with the standout being NT-proBNP, which is currently used in monitoring heart failure status. The team found that NT-proBNP showed consistently high predictive value across studies, including one with a cohort of 16,000 people in which the data showed a 64% hazard rate increase for every standard deviation increase of NT-proBNP.
“Our findings suggest that NT-proBNP, beyond its established role in the diagnosis and management of patients with heart failure, might also be used as a marker to predict CVD [cardiovascular disease],” the authors wrote.
While noting the limitations of their study -- e.g., the omission of “a considerable number of cross-sectional studies due to the extensive scope of the systematic review and the explained focus on longitudinal studies” and the inclusion of only English-language publications -- and that further studies would be needed to determine the utility of their findings, the researchers also noted that the findings “could potentially be used to enable clinicians to provide targeted advice and treatment to those people with T2D [type 2 diabetes] at most risk of developing CVD.”
The research was conducted as part of the Precision Medicine in Diabetes Initiative, established by the American Diabetes Association in partnership with the European Association for the Study of Diabetes.