Aim: To investigate the association between cardiovascular risk and biomarkers in patients with Type 2 diabetes (T2DM). Methods: Cross-sectional study, with evaluation of traditional and new biomarkers (serum FGF-23, Syndecan-1 – Sdc-1 and vascular cell adhesion molecule-1 – VCAM-1 and urinary VEGF and kidney injury molecule-1 – KIM-1) and risk scores (Framingham-FRS and UK Prospective Diabetes Study – UKPDS). Results: 128 diabetics were included, with predominance of high risk by FRS and low risk by UKPDS. There was an independent association of VCAM-1 and VEGF with higher risk by FRS-lipids and UKPDS. Conclusion: There was an independent association of VCAM-1 and VEGF with higher cardiovascular risk, showing a subclinical endothelial dysfunction in T2DM. The inclusion of novel biomarkers to risk scores may increase accuracy when assessing cardiovascular risk of diabetic individuals.
Previous analyses of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) identified four main dietary patterns (DP). The aim of this study was to explore the association between the previously defined DP and renal function (RF). A crosssectional study using the ELSA-Brasil baseline data was carried out. DP (''traditional'', ''fruits and vegetables'', ''bakery'', and ''low sugar/low fat), metabolic syndrome (MS) using the Joint Interim Statement criteria, microalbuminuria (MA), and glomerular filtration rate (eGFR) through the CKD-EPI equation were evaluated. Abnormal RF was defined as eGFRo60 mL Á min -1 Á (1.73 m 2 ) -1 and MAX3.0 mg/dL. Factors associated with RF were determined and mediation analysis was performed to investigate the association between DP, MS, and RF. A total of 15,105 participants were recruited, with a mean age of 52 ± 9 years; 8,134 participants (54%) were females. The mediation analysis identified indirect associations between ''bakery'' and ''fruits and vegetables'', and both were associated with decreased eGFR and albuminuria in both genders, compared with ''traditional'' and ''low sugar/low fat'' patterns in the general population. There was a direct association of the ''bakery'' pattern with MA in men (OR: 1.17, 95%CI: 1.92-1.48). The ''fruits and vegetables'' pattern also showed a direct association with reduced eGFR in women (OR: 1.65, 95%CI: 1.28-2.12), although there was no significance after adjustment. The ''fruits and vegetables'' and ''bakery'' DPs were associated with renal dysfunction. The only independent, direct association was between ''bakery'' DP and MA in men, raising concerns about DP and renal damage in men.
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