ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2019) 63 GP35 | DOI: 10.1530/endoabs.63.GP35

Cardiovascular biomarkers and calculated risks - an association study

Alexandra Markova1,2, Mihail Boyanov1,2, Deniz Bakalov1,2 & Adelina Tsakova3,4


1Clinic of Endocrinology and Metabolism, University Hospital Alexandrovska, Sofia, Bulgaria; 2Department Internal Medicine, Medical University Sofia, Sofia, Bulgaria; 3Central Clinical Laboratory, University Hospital Alexandrovska, Sofia, Bulgaria; 4Department Clinical Laboratory and Clinical Immunology, Medical University Sofia, Sofia, Bulgaria.


The identification of type 2 diabetes patients at particularly high risk for cardiovascular events might be facilitated by the use of specific risk calculators or by measurements of serum biomarkers.

Objectives: To correlate the levels of cardiovascular biomarkers – assymetric dymethylarginine (ADMA), endothelin 1 (ET-1), N-terminal brain natriuretic pro-peptide (NT-proBNP) and placental growth factor (PIGF-1), with calculated cardiovascular risks using three different risk engines.

Material and methods: 102 women and 67 men with type 2 diabetes on oral antidiabetic drugs agreed to participate in this cross-sectional study (mean age – 60.3±9.6 years; mean diabetes duration – 7.6 years). Fasting morning blood and urine samples were collected and the glycemic and metabolic parameters were assessed by routine laboratory (glycated hemoglobin A1c, lipid profiles, creatinine, microalbuminuria etc.). Serum levels of NT-proBNP and PIGF-1 were measured by electro-hemi-luminescence (Elecsys 2010, Roche Diagnostics) while enzymatic immunoassays were used for ADMA (BioVendor) and ET-1 (IBL International GMBH). Cardiovascular risks were calculated using the Framingham Risk Score (FRS), the UKPDS version 2.0 and the ADVANCE risk engines. Correlation and regression analysis were performed on an IBM SPSS 19.0 for Windows platform (SPSS Corp., Chicago, IL).

Results: ADMA levels were above the upper normal limit in 11.0% of the participants, ET-1 levels - in 20.4%, and NT-proBNP - in 33.5%. Based on the ADVANCE risk calculator 10.8% of the participants had a 4-yr risk for CV events ≥ 8.0%. The FRS based 10-yr risk was very high (> 20%) in 8.0% of the participants, and moderate (15 – 30%) – in 12.1%. The UKPDS-based risk was very high (>30%) in less than 20% of the participants. Levels of PIGF-1 showed no correlation with the calculated CV risks, the same was true for levels of ADMA, except for UKPDS-based 10-yr risk for stroke. Plasma levels of endothelin-1 were correlated only with the UKPDS-based 10-yr risk for stroke and fatal stroke, while NT-proBNP levels were highly and significantly correlated with all possible CV risk calculations. The curve estimations within the regression analyses produced similar results.

Conclusion: Serum levels of ADMA and PIGF-1 do not seem related to calculated cardiovascular risks. ET-1 is linked to risk for stroke, while NT-proBNP - to both cardio- and cerebrovascular risk estimations.

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