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Klisic A, Kotur-Stevuljevic J, Ninic A. Endocan is Related to Increased Cardiovascular Risk in Type 2 Diabetes Mellitus Patients. Metab Syndr Relat Disord 2023; 21:362-369. [PMID: 37279462 DOI: 10.1089/met.2023.0050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Abstract
Aim: Type 2 diabetes mellitus (T2D) patients have an increased risk for cardiovascular disease (CVD). Different algorithms are used for the CVD risk quantification and United Kingdom Prospective Diabetes Study (UKPDS) score was among the most validated. Endocan is a novel endothelial dysfunction marker. The aim was to explore the potential relationship between serum endocan level and UKPDS risk engine score [which enables calculation of the 10-year risk of nonfatal and fatal coronary heart disease (eCHD) and stroke] in T2D patients. Materials and Methods: The study included a cohort of 104 patients with T2D (of them 52.8% men), with median age 66 years and body mass index (BMI) = 30.7 kg/m2. Patients were divided into: low (<15%), moderate (≥15% and <30%), and high-risk UKPDS category (≥30%). Results: In multivariable regression analysis (when adjusted for sex, BMI and/or hip circumference), endocan was the independent predictor for moderate and high estimated risks (nonfatal eCHD, fatal eCHD, and nonfatal stroke risk). In the Model for high nonfatal eCHD [areas under curve (AUC) = 0.895] and high fatal eCHD (AUC = 0.860) endocan indicated good clinical accuracy, and an excellent accuracy in discriminating patients with high risk for nonfatal stroke risk (AUC = 0.945). Conclusion: Endocan was the independent predictor for moderate and high estimated risks (i.e., nonfatal and fatal CHD and nonfatal stroke risk scores) in T2D patients. When included in models with sex and obesity indices endocan demonstrated good clinical accuracy in discriminating T2D patients with high risk for nonfatal and fatal eCHD and nonfatal stroke risk from those patients with low risk.
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Affiliation(s)
- Aleksandra Klisic
- Department of Biochemistry, Faculty of Medicine, University of Montenegro, Podgorica, Montenegro
- Center for Laboratory Diagnostics, Primary Health Care Center, Podgorica, Montenegro
| | - Jelena Kotur-Stevuljevic
- Department for Medical Biochemistry, University of Belgrade-Faculty of Pharmacy, Belgrade, Serbia
| | - Ana Ninic
- Department for Medical Biochemistry, University of Belgrade-Faculty of Pharmacy, Belgrade, Serbia
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Seferović P, Farmakis D, Bayes-Genis A, Ben Gal T, Böhm M, Chioncel O, Ferrari R, Filippatos G, Hill L, Jankowska E, Lainscak M, Lopatin Y, Lund LH, Mebazaa A, Metra M, Moura B, Rosano G, Thum T, Voors A, Coats AJS. 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. Eur J Heart Fail 2022; 24:1162-1170. [PMID: 35703329 DOI: 10.1002/ejhf.2575] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 05/21/2022] [Accepted: 06/13/2022] [Indexed: 11/08/2022] Open
Abstract
Knowledge on risk predictors of incident heart failure (HF) in patients with type 2 diabetes (T2D) is crucial given the frequent coexistence of the two conditions and the fact that T2D doubles the risk of incident HF. In addition, HF is increasingly being recognized as an important endpoint in trials in T2D. On the other hand, the diagnostic and prognostic performance of established cardiovascular biomarkers may be modified by the presence of T2D. The present position paper, derived by an expert panel workshop organized by the Heart Failure Association of the European Society of Cardiology, summarizes the current knowledge and gaps in evidence regarding the use of a series of different biomarkers, reflecting various pathogenic pathways, for the prediction of incident HF and cardiovascular events in patients with T2D and in those with established HF and T2D.
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Affiliation(s)
- Peter Seferović
- Faculty of Medicine, University of Belgrade Belgrade, Serbia and Serbian Academy of Sciences and Arts, Belgrade, Serbia.,University of Belgrade Belgrade, Belgrade, Serbia
| | | | - Antoni Bayes-Genis
- Heart Institute, Hospital Universitari German Trias i Pujol, Badalona, Spain.,Department of Medicine, Universitat Autónoma de Barcelona, Barcelona, Spain.,CIBERCV, Instituto de Salud, Madrid, Spain
| | - Tuvia Ben Gal
- Heart Failure Unit, Cardiology Department, Rabin Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michael Böhm
- Klinik für Innere Medizin III, Universitätsklinikum des Saarlandes, Saarland University, Homburg, Germany
| | - Ovidiu Chioncel
- Emergency Institute for Cardiovascular Diseases 'Prof. C.C. Iliescu', Bucharest, and University of Medicine Carol Davila, Bucharest, Romania
| | - Roberto Ferrari
- Maria Cecilia Hospital, GVM Care & Research, Ravenna, Italy.,Laboratory for Technologies of Advanced Therapies (LTTA), Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - Gerasimos Filippatos
- Second Department of Cardiology, Athens University Hospital Attikon, National and Kapodistrina University of Athens Medical School, Athens, Greece
| | - Loreena Hill
- School of Nursing and Midwifery, Queen's University, Belfast, UK
| | - Ewa Jankowska
- Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland.,Centre for Heart Diseases, University Hospital, Wroclaw, Poland
| | - Mitja Lainscak
- Division of Cardiology, General Hospital Murska Sobota, Murska Sobota, Slovenia, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Yuri Lopatin
- Volgograd State Medical University, Regional Cardiology Centre Volgograd, Volgograd, Russian Federation
| | - Lars H Lund
- Department of Medicine, Karolinska Institutet, and Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden
| | - Alexandre Mebazaa
- INSERM UMR-S 942, Paris, France; Department of Anesthesiology and Critical Care Medicine, St. Louis and Lariboisère University Hospitals, Paris, France
| | - Marco Metra
- Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Brenda Moura
- CINTESIS - Centro de Investigação em Tecnologias e Serviços de Saúde, Porto, Portugal; Serviço de Cardiologia, Hospital das Forças Armadas - Pólo do Porto, Porto, Portugal
| | - Giuseppe Rosano
- Cardiovascular Clinical Academic Group, St George's Hospitals NHS Trust University of London, London, UK.,IRCCS San Raffaele Pisana, Rome, Italy
| | - Thomas Thum
- Institute of Molecular and Translational Therapeutic Strategies, Hannover Medical School, Hannover, Germany.,REBIRTH Center for Translational Regenerative Medicine, Hannover Medical School, Hannover, Germany.,Fraunhofer Institute for Toxicology and Experimental Medicine, Hannover, Germany
| | - Adriaan Voors
- Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Zhang Y, Li H, Wang C, Lv H, Fu S. Toll like receptor 4 gene Asp299Gly polymorphism increases the risk of diabetic microvascular complications: a meta analysis. Diabetol Metab Syndr 2022; 14:79. [PMID: 35672795 PMCID: PMC9172045 DOI: 10.1186/s13098-022-00849-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 05/29/2022] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE The relationship between Toll like receptor 4(TLR4) gene Asp299Gly polymorphism and diabetic microvascular complications (DMI) is unclear. Therefore, the aim of this meta analysis was to explore the relationship between TLR4 Asp299Gly polymorphism and DMI. METHODS System search PubMed, Web of science, Springer, Cochrane library, ELSEVIER, Wanfang database, VIP, CNKI, a case-control study of the correlation between TLR4 gene Asp299Gly polymorphism and DMI published before June 2020 was collected. RESULTS We included 6 articles, a total of 11 studies involving patients with type 2 diabetes mellitus (T2DM) complicated by microvascular complications 1834 cases, without corresponding microvascular complications 4069 cases. TLR4 gene Asp299Gly polymorphism increased the risk of microvascular complications in T2DM (dominant model OR = 1.52, 95% CI 1.10-2.09, p = 0.01; allelic model OR = 1.42, 95% CI 1.02-1.96, p = 0.04). Subgroup analysis by race and different type of microvascular complications, we found that TLR4 gene Asp299Gly polymorphism was associated with increased risk of microvascular complications in the Caucasian population (dominant model OR = 1.69, 95% CI 1.22-2.35, P = 0.002; allelic model OR = 1.56, 95% CI 1.10-2.21, P = 0.01) and increased the risk of retinopathy in patients with T2DM(dominant model OR = 1.81, 95% CI 1.04-3.14, P = 0.03; allelic model OR = 1.77, 95% CI 1.05-2.98, P = 0.03). CONCLUSION TLR4 gene Asp299Gly polymorphism was associated with increased risk of microvascular complications in patients with T2DM, especially diabetic retinopathy (DR).
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Affiliation(s)
- Yuqi Zhang
- Department of Endocrinology, The First Hospital of Lanzhou University, No. 1 Donggang West Road, Lanzhou, 730000 Gansu People’s Republic of China
- The First Clinical Medical College of Lanzhou University, Lanzhou, 730000 Gansu People’s Republic of China
| | - Huanhuan Li
- Department of Endocrinology, The First Hospital of Lanzhou University, No. 1 Donggang West Road, Lanzhou, 730000 Gansu People’s Republic of China
- The First Clinical Medical College of Lanzhou University, Lanzhou, 730000 Gansu People’s Republic of China
| | - Chenyi Wang
- Department of Endocrinology, The First Hospital of Lanzhou University, No. 1 Donggang West Road, Lanzhou, 730000 Gansu People’s Republic of China
- The First Clinical Medical College of Lanzhou University, Lanzhou, 730000 Gansu People’s Republic of China
| | - Haihong Lv
- Department of Endocrinology, The First Hospital of Lanzhou University, No. 1 Donggang West Road, Lanzhou, 730000 Gansu People’s Republic of China
| | - Songbo Fu
- Department of Endocrinology, The First Hospital of Lanzhou University, No. 1 Donggang West Road, Lanzhou, 730000 Gansu People’s Republic of China
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