Associations of cardiac stress biomarkers with incident type 2 diabetes and changes in glucose metabolism: KORA F4/FF4 study

Cardiovascular Diabetology

Wolfgang Koenig¹  Michael Roden²  Christian Herder²  Wolfgang Rathmann³  Ulrich Mansmann⁴  Jens Jordan⁵  Annette Peters⁶  Barbara Thorand⁶  Chaterina Sujana⁷  Cornelia Then⁸  Jochen Seissler⁸ 

[1] Deutsches Herzzentrum München, Technische Universität München, Munich, Germany;German Centre for Cardiovascular Research (DZHK), Partner Site Munich Heart Alliance, Munich, Germany;Institute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany;German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany;Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany;Division of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany;Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany;German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany;Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Ludwig-Maximilians-Universität, Munich, Germany;Pettenkofer School of Public Health, Munich, Germany;Institute of Aerospace Medicine, German Aerospace Center (DLR) and University of Cologne, Cologne, Germany;Institute of Epidemiology, Helmholtz Zentrum München-German Research Centre for Environmental Health, Ingolstädter Landstrasse 1, 85764, Neuherberg, Germany;German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany;Institute of Epidemiology, Helmholtz Zentrum München-German Research Centre for Environmental Health, Ingolstädter Landstrasse 1, 85764, Neuherberg, Germany;Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Ludwig-Maximilians-Universität, Munich, Germany;Pettenkofer School of Public Health, Munich, Germany;Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ludwig-Maximilians-Universität, Munich, Germany;

关键词: MR-proANP;    Copeptin;    CT-proET-1;    MR-proADM;    Cardiac stress biomarkers;    Type 2 diabetes;    Prediabetes;    Insulin resistance;    Incidence;    Cohort study;   

DOI  :  10.1186/s12933-020-01117-1

来源: Springer

【 摘 要 】

BackgroundHigh N-terminal pro-brain-type natriuretic peptide levels have been associated with a lower risk of type 2 diabetes mellitus (T2D). However, less is known about other cardiac stress biomarkers in this context. Here we evaluated the association of mid-regional pro-atrial natriuretic peptide (MR-proANP), C-terminal pro-arginine vasopressin (copeptin), C-terminal pro-endothelin-1 (CT-proET-1) and mid-regional pro-adrenomedullin (MR-proADM) with incident T2D and changes in glucose metabolism.MethodsWe performed a prospective cohort study using data from the population-based KORA F4/FF4 study. 1773 participants (52.3% women) with MR-proANP measurements and 960 (52.7% women) with copeptin, CT-proET-1 and MR-proADM measurements were included. We examined associations of circulating plasma levels of MR-proANP, copeptin, CT-proET-1 and MR-proADM with incident T2D, the combined endpoint of incident prediabetes/T2D and with fasting and 2 h-glucose, fasting insulin, HOMA-IR, HOMA-B and HbA1c at follow-up. Logistic and linear regression models adjusted for age, sex, waist circumference, height, hypertension, total/HDL cholesterol ratio, triglycerides, smoking, physical activity and parental history of diabetes were used to compute effect estimates.ResultsDuring a median follow-up time of 6.4 years (25th and 75th percentiles: 6.0 and 6.6, respectively), 119 out of the 1773 participants and 72 out of the 960 participants developed T2D. MR-proANP was inversely associated with incident T2D (odds ratio [95% confidence interval]: 0.75 [0.58; 0.96] per 1-SD increase of log MR-proANP). Copeptin was positively associated with incident prediabetes/T2D (1.29 [1.02; 1.63] per 1-SD increase of log copeptin). Elevated levels of CT-proET-1 were associated with increased HOMA-B at follow-up, while elevated MR-proADM levels were associated with increased fasting insulin, HOMA-IR and HOMA-B at follow-up. These associations were independent of previously described diabetes risk factors.ConclusionsHigh plasma concentrations of MR-proANP contributed to a lower risk of incident T2D, whereas high plasma concentrations of copeptin were associated with an increased risk of incident prediabetes/T2D. Furthermore, high plasma concentrations of CT-proET-1 and MR-proADM were associated with increased insulin resistance. Our study provides evidence that biomarkers implicated in cardiac stress are associated with incident T2D and changes in glucose metabolism.

【 授权许可】

CC BY