TY - JOUR
T1 - Heart failure and inflammation-related biomarkers as predictors of new-onset diabetes in the general population
AU - Suthahar, Navin
AU - Meijers, Wouter C.
AU - Brouwers, Frank P.
AU - Heerspink, Hiddo J.L.
AU - Gansevoort, Ron T.
AU - van der Harst, Pim
AU - Bakker, Stephan J.L.
AU - de Boer, Rudolf A.
N1 - Publisher Copyright:
© 2017 Elsevier B.V.
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Background:There is a strong reciprocal relationship between heart failure (HF) and diabetes mellitus (DM). Shared pathophysiological mechanisms might be a possible explanation. Therefore, we hypothesised that biomarkers linked to HF would also predict new-onset type 2 DM in the general population. Methods and results: We utilized the Prevention of Vascular and Renal End-stage Disease (PREVEND) cohort (mean age 48.9 years, 51% female) to study the relationship between HF and DM in 7953 participants free of baseline HF and DM. Multiple HF-related, inflammation-related and renal function-related biomarkers were evaluated regarding their predictive utility in new-onset DM. Incidence of DM in participants who developed HF was 11.8%, versus 5.4% in those who had not developed HF (p < 0.001). Incidence of HF in participants who developed DM was 8.5%, versus 3.8% in those who had not developed DM (p < 0.001). Classical HF biomarkers, NT-proBNP and hs-TnT were not associated with an increased risk for new-onset DM. However, inflammatory biomarkers hs-CRP [hazard ratio (HR) 1.16, (95% CI 1.05 to 1.29), p = 0.005], procalcitonin [HR 1.34, (95% CI 1.07 to 1.69), p = 0.012] and PAI-1 [HR 1.55, (95% CI 1.37 to 1.75), p < 0.001] remained significantly associated with new-onset DM, even after multivariable adjustment for established predictors of DM. Conclusions: Although HF and DM have a strong correlation with each other, systemic biomarkers that predict HF do not have a predictive value in new-onset DM. This suggests that other, indirect, pathophysiological mechanisms related to inflammation may explain their strong relation.
AB - Background:There is a strong reciprocal relationship between heart failure (HF) and diabetes mellitus (DM). Shared pathophysiological mechanisms might be a possible explanation. Therefore, we hypothesised that biomarkers linked to HF would also predict new-onset type 2 DM in the general population. Methods and results: We utilized the Prevention of Vascular and Renal End-stage Disease (PREVEND) cohort (mean age 48.9 years, 51% female) to study the relationship between HF and DM in 7953 participants free of baseline HF and DM. Multiple HF-related, inflammation-related and renal function-related biomarkers were evaluated regarding their predictive utility in new-onset DM. Incidence of DM in participants who developed HF was 11.8%, versus 5.4% in those who had not developed HF (p < 0.001). Incidence of HF in participants who developed DM was 8.5%, versus 3.8% in those who had not developed DM (p < 0.001). Classical HF biomarkers, NT-proBNP and hs-TnT were not associated with an increased risk for new-onset DM. However, inflammatory biomarkers hs-CRP [hazard ratio (HR) 1.16, (95% CI 1.05 to 1.29), p = 0.005], procalcitonin [HR 1.34, (95% CI 1.07 to 1.69), p = 0.012] and PAI-1 [HR 1.55, (95% CI 1.37 to 1.75), p < 0.001] remained significantly associated with new-onset DM, even after multivariable adjustment for established predictors of DM. Conclusions: Although HF and DM have a strong correlation with each other, systemic biomarkers that predict HF do not have a predictive value in new-onset DM. This suggests that other, indirect, pathophysiological mechanisms related to inflammation may explain their strong relation.
UR - http://www.scopus.com/inward/record.url?scp=85034700763&partnerID=8YFLogxK
U2 - 10.1016/j.ijcard.2017.10.035
DO - 10.1016/j.ijcard.2017.10.035
M3 - Article
C2 - 29074040
AN - SCOPUS:85034700763
SN - 0167-5273
VL - 250
SP - 188
EP - 194
JO - International Journal of Cardiology
JF - International Journal of Cardiology
ER -
