Navin Suthahar1, Wouter C Meijers1, Frank P Brouwers1, Hiddo J L Heerspink2, Ron T Gansevoort3, Pim van der Harst1, Stephan J L Bakker3, Rudolf A de Boer4. 1. Department of Cardiology, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands. 2. Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands. 3. Department of Nephrology, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands. 4. Department of Cardiology, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands. Electronic address: r.a.de.boer@umcg.nl.
Abstract
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 48.9years, 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.
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 48.9years, 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.
Authors: Navin Suthahar; Wouter C Meijers; Jennifer E Ho; Ron T Gansevoort; Adriaan A Voors; Peter van der Meer; Stephan J L Bakker; Stephane Heymans; Vanessa van Empel; Blanche Schroen; Pim van der Harst; Dirk J van Veldhuisen; Rudolf A de Boer Journal: Eur J Heart Fail Date: 2018-06-01 Impact factor: 15.534
Authors: Chaterina Sujana; Veikko Salomaa; Frank Kee; Jochen Seissler; Pekka Jousilahti; Charlotte Neville; Cornelia Then; Wolfgang Koenig; Kari Kuulasmaa; Jaakko Reinikainen; Stefan Blankenberg; Tanja Zeller; Christian Herder; Ulrich Mansmann; Annette Peters; Barbara Thorand Journal: Cardiovasc Diabetol Date: 2022-06-09 Impact factor: 8.949
Authors: Nonhlakanipho F Sangweni; Phiwayinkosi V Dludla; Rebamang A Mosa; Abidemi P Kappo; Andy Opoku; Christo J F Muller; Rabia Johnson Journal: Heart Fail Rev Date: 2019-01 Impact factor: 4.214
Authors: Just Dronkers; Laura M G Meems; Dirk J van Veldhuisen; Sven Meyer; Lyanne M Kieneker; Ron T Gansevoort; Stephan J L Bakker; Michiel Rienstra; Rudolf A de Boer; Navin Suthahar Journal: Eur Heart J Open Date: 2022-03-14