Cardiovascular Biomarkers in Routine Screening of Diabetic Pati ents

Abstract

Type 2 diabetes mellitus (T2DM) is one of the most prevalent metabolic diseases that associated with increased risk for cardiovascular (CV) diseases and newly CV events. Although CV risk assessment is incorporated in primary and secondary prevention strategies to improve morbidity and mortality that are applied in diabetic patient, it is important to stratify individuals at high CV risk not just prior diabetic complication, but at early stages of development of the CV diseases. The aim of the editorial comment is to discuss possible predictive role of cardiac biomarkers in T2DM. CV biomarkers may contribute to improved prediction of mortality and CV events in T2DM. It has suggested that measurement of serum levels of hs-CRP, galectin-3, natriuretic peptides, fibroblast growth factor-23, α-klotho, and hs-cTnT probably allows the screening of diabetes patients at risk of CV events. Future directions are associated with discovering of novel biomarkers and optimal combinations of recently used markers to provide additional prognostic information beyond what is available with other traditional CV risk factors.

An association of serum vistafin level and number of circulating endothelial progenitor cells in type 2 diabetes mellitus patients

“…EPCs are mobilized from bone marrow and probably from peripheral tissues upon injury in result in growth factors and inflammatory cytokines [20]. Decreased numerous of circulating EPCs was found a marker of impaired endothelial function and early atherosclerosis [21][22][23][24]. Therefore, increased production of reactive oxygen species, insulin resistance, reduced NO bioavailability have been identified as mediators of tissue injury leading to lowered EPC functionality and reduced angiogenic capacity in vivo [25][26][27].…”

Biomarkers Through The Development, Progression and Chronic Complications of Diabetes Mellitus: A Mini-Review

“…The large amount of literature regarding the use of cardiac biomarkers in T2DM detection has accentuated the need of discussing the clinical utility of markers of cardiac biochemical stress, vascular remodeling and low-grade inflammation, such as natriuretic peptides (NPs), galectin-3 (Gal-3), interleukins and growth differentiation factor-15 (GDF-15) [35,36,37]. These biomarkers have been proposed as future candidates of diagnostic or prognostic value in diabetic patients [37].…”

“…Thus, their role in T2DM progression appears to be strongly controversial. Consequently, the NP system in obese and diabetic patients is not able to mediate a wide spectrum of cardiovascular and metabolic protective effects that involve mechanisms of vasodilation, natriuresis, lipolysis, weight loss, lusitropy, lipid peroxidation, mitochondrial respiration improvement and insulin sensitivity [37]. However, according to contemporary clinical guidelines for heart failure, NPs are recognized as powerful biomarkers for acute coronary syndrome and cardiac cytotoxicity, and they provide more accurate diagnostic and predictive values [38,39].…”

“…Thus, isolated obesity remains the crucial condition for decision-making regarding predictive role of NPs and requires more scrutiny [44]. Given all these limitations and controversies, NPs are proposed diagnostic biomarkers linking T2DM with cardiovascular (CV) risk and CV outcomes [37].…”

Single sample and serial measurements of osteoprotegerin level as a target of therapy in type 2 diabetes mellitus?

“…However, contemporary treatment approaches based on improved glycemic control have been exhibited an ability to contribute in decreased CV complications related to T2DM, whereas utilization of modern strategy is higher cost and appears to be economic challenge to the health care system [4][5][6]. In this context, several circulating biomarkers represented differential metabolic profiles, related to vascular complications and predicted CV events may be clinically helpful for risk stratification and individualized treatment for T2DM patients [7,8]. Although various biomarkers (natriuretic peptides, galectin-3, soluble ST2, growth-differentiation factor-15, signature of microRNAs, oxidative stress components, inflammatory cytokines, biomarkers of coagulation and endothelial damage) are widely used as predictors of adverse clinical outcomes in several settings [9][10][11][12], there is concern regarding their role as biological target in T2DM care [8,13].…”