Cardiovascular Biomarkers and Calculated Cardiovascular Risk in Orally Treated Type 2 Diabetes Patients: Is There a Link?

Abstract

<jats:title>Abstract</jats:title><jats:p>The aim of the study was to test the correlation of serum levels of asymmetric dimethylarginine (ADMA), endothelin 1 (ET-1), N-terminal brain natriuretic pro-peptide (NT-proBNP), and placental growth factor (PIGF-1) with estimated cardiovascular (CV) risk. The study group was composed of 102 women and 67 men with type 2 diabetes, having their glycemic and metabolic parameters assessed. All were on oral antidiabetic drugs. Serum levels of NT-proBNP and PIGF-1 were measured by electro-hemi-luminescence on an Elecsys 2010 analyzer. Enzymatic immunoassays were used for ADMA and ET-1. The Framingham Risk Score (FRS), the UKPDS 2.0 and the ADVANCE risk engines were used to calculate cardiovascular risks while statistical analysis was performed on SPSS. Levels of PIGF-1 showed no correlation with the calculated CV risks. The same was true for ADMA, except for a weak correlation with the UKPDS-based 10-year risk for stroke (Pearsons’s R=0.167, p=0.039). Plasma levels of ET-1 were correlated with the UKPDS-based 10-year risk for stroke (R=0.184, p=0.032) and fatal stroke (R=0.215, p=0.012) only. NT-proBNP was significantly correlated with all CV risk calculations: ADVANCE-based 4-yr risk (Spearman’s Rho=0.521, p&lt;0.001); UKPDS-based 10-year risk for: CHD (Rho=0.209, p=0.01), fatal CHD (Rho=0.282, p&lt;0.001), stroke (Rho=0.482, p&lt;0.001), fatal stroke (Rho=0.505, p&lt;0.001); and 10-year FRS risk (Rho=0.246, p=0.002). In conclusion, ADMA and PIGF-1 did not seem useful in stratifying CV risk while ET-1 is linked to the risk of stroke, and NT-proBNP to all CV risk estimations.</jats:p>

VCAM-1 Is Associated With High Cardiovascular Risk Predicted by the Framingham Score: A Cross-Sectional Study With Diabetic Women

“…This study showed that ADMA and PIGF-1 were not associated with CVR strati cation with any of the scores, while ET-1 was associated with the risk of stroke by the UKPDS and NT-proBNP was associated with CVR predicted by both tools. [39] Different from our research, these studies did not evaluate the female diabetic population, or the biomarkers analyzed by us.…”

“…[35] Few studies in the literature have attempted to correlate the use of biomarkers, especially those analyzed in the present study, and the CVR predicted by scores in the diabetic population. [36][37][38][39][40][41] One of these studies evaluated the association between a set of biomarkers that analyze different metabolic pathways, such as Asymmetric dimethylarginine (ADMA), Soluble endothelin-1 (ET-1), Placental growth factor-1 (PIGF-1) and NT-pro-BNP and the CVR predicted by the UKPDS and Action in Diabetes and Vascular disease (ADVANCE) scores in diabetic patients. This study showed that ADMA and PIGF-1 were not associated with CVR strati cation with any of the scores, while ET-1 was associated with the risk of stroke by the UKPDS and NT-proBNP was associated with CVR predicted by both tools.…”

Biomarkers for the prediction of heart failure and cardiovascular events in patients with type 2 diabetes: a position statement from the Heart Failure Association of the European Society of Cardiology

“…A study on 169 patients with T2D evaluated the prognostic value of a series of alternative biomarkers including asymmetric dimethylarginine, a marker of endothelial dysfunction, endothelin‐1, an inflammatory marker and placental growth factor, another vascular index, along with NT‐proBNP 45 . Among these biomarkers, only NT‐proBNP was significantly correlated with the risk of coronary artery or cerebrovascular disease and the CV risk predicted by calculators such as the ADVANCE, the UKPDS 2.0 and the Framingham risk score.…”