scholarly journals Opposing associations of NT-proBNP with risks of diabetes and diabetes-related complications

Author(s):  
Anna Birukov ◽  
Fabian Eichelmann ◽  
Olga Kuxhaus ◽  
Elli Polemiti ◽  
Andreas Fritsche ◽  
...  

<b>Objective:</b> Circulating N-terminal pro b-type natriuretic peptide (NT-proBNP) is a classic diagnostic and prognostic marker for heart failure. However, it is inversely associated with diabetes risk. We aimed to investigate relationships of NT-proBNP with risk of diabetes-related complications in initially healthy individuals. <p><b>Research Design and Methods:</b> <a>We performed a case-cohort study within the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam cohort including a random subcohort (n=1294) and incident cases of type 2 diabetes (n=649) and cardiovascular diseases (CVD, n=478). Incident cases of type 2 diabetes (n=545) were followed up for micro- (n=133) and macrovascular (n=50) complications. Plasma NT-proBNP was measured at baseline in initially healthy participants.</a></p> <p><b>Results: </b><a></a><a>In multivariable models, NT-proBNP was linearly inversely associated with incident type 2 diabetes, HR (95% CI) per doubling in NT-proBNP: 0.91 (0.86; 0.98). The association was only observable in women, HR (95%CI): 0.80 (0.72; 0.90), compared to 0.98 (0.91; 1.07) in men. Among persons with incident diabetes, NT-proBNP was positively associated with diabetes complications, HR (95% CI): 1.31 (1.13; 1.53) for overall, 1.20 (1.01; 1.43) for micro- and 1.37 (1.03; 1.83) for macrovascular complications. </a></p> <b>Conclusions: </b><a>Although higher NT-proBNP levels are associated with lower diabetes risk, in persons who develop diabetes NT-proBNP is a biomarker for vascular complications independent of potential confounders. </a><a>Thus, NT-proBNP might be informative to monitor risk for diabetes-related micro- and macrovascular complications, which should be further explored in future prospective studies.</a>

2020 ◽  
Author(s):  
Anna Birukov ◽  
Fabian Eichelmann ◽  
Olga Kuxhaus ◽  
Elli Polemiti ◽  
Andreas Fritsche ◽  
...  

<b>Objective:</b> Circulating N-terminal pro b-type natriuretic peptide (NT-proBNP) is a classic diagnostic and prognostic marker for heart failure. However, it is inversely associated with diabetes risk. We aimed to investigate relationships of NT-proBNP with risk of diabetes-related complications in initially healthy individuals. <p><b>Research Design and Methods:</b> <a>We performed a case-cohort study within the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam cohort including a random subcohort (n=1294) and incident cases of type 2 diabetes (n=649) and cardiovascular diseases (CVD, n=478). Incident cases of type 2 diabetes (n=545) were followed up for micro- (n=133) and macrovascular (n=50) complications. Plasma NT-proBNP was measured at baseline in initially healthy participants.</a></p> <p><b>Results: </b><a></a><a>In multivariable models, NT-proBNP was linearly inversely associated with incident type 2 diabetes, HR (95% CI) per doubling in NT-proBNP: 0.91 (0.86; 0.98). The association was only observable in women, HR (95%CI): 0.80 (0.72; 0.90), compared to 0.98 (0.91; 1.07) in men. Among persons with incident diabetes, NT-proBNP was positively associated with diabetes complications, HR (95% CI): 1.31 (1.13; 1.53) for overall, 1.20 (1.01; 1.43) for micro- and 1.37 (1.03; 1.83) for macrovascular complications. </a></p> <b>Conclusions: </b><a>Although higher NT-proBNP levels are associated with lower diabetes risk, in persons who develop diabetes NT-proBNP is a biomarker for vascular complications independent of potential confounders. </a><a>Thus, NT-proBNP might be informative to monitor risk for diabetes-related micro- and macrovascular complications, which should be further explored in future prospective studies.</a>


Diabetologia ◽  
2021 ◽  
Author(s):  
Elli Polemiti ◽  
Julia Baudry ◽  
Olga Kuxhaus ◽  
Susanne Jäger ◽  
Manuela M. Bergmann ◽  
...  

Abstract Aims/hypothesis Studies suggest decreased mortality risk among people who are overweight or obese compared with individuals with normal weight in type 2 diabetes (obesity paradox). However, the relationship between body weight or weight change and microvascular vs macrovascular complications of type 2 diabetes remains unresolved. We investigated the association between BMI and BMI change with long-term risk of microvascular and macrovascular complications in type 2 diabetes in a prospective cohort study. Methods We studied participants with incident type 2 diabetes from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam cohort, who were free of cancer, cardiovascular disease and microvascular disease at diagnosis (n = 1083). Pre-diagnosis BMI and relative annual change between pre- and post-diagnosis BMI were evaluated in multivariable-adjusted Cox models. Results There were 85 macrovascular (myocardial infarction and stroke) and 347 microvascular events (kidney disease, neuropathy and retinopathy) over a median follow-up of 10.8 years. Median pre-diagnosis BMI was 29.9 kg/m2 (IQR 27.4–33.2), and the median relative annual BMI change was −0.4% (IQR −2.1 to 0.9). Higher pre-diagnosis BMI was positively associated with total microvascular complications (multivariable-adjusted HR per 5 kg/m2 [95% CI]: 1.21 [1.07, 1.36], kidney disease 1.39 [1.21, 1.60] and neuropathy 1.12 [0.96, 1.31]) but not with macrovascular complications (HR 1.05 [95% CI 0.81, 1.36]). Analyses according to BMI categories corroborated these findings. Effect modification was not evident by sex, smoking status or age groups. In analyses according to BMI change categories, BMI loss of more than 1% indicated a decreased risk of total microvascular complications (HR 0.62 [95% CI 0.47, 0.80]), kidney disease (HR 0.57 [95% CI 0.40, 0.81]) and neuropathy (HR 0.73 [95% CI 0.52, 1.03]), compared with participants with a stable BMI; no clear association was observed for macrovascular complications (HR 1.04 [95% CI 0.62, 1.74]). The associations between BMI gain compared with stable BMI and diabetes-related vascular complications were less apparent. Associations were consistent across strata of sex, age, pre-diagnosis BMI or medication but appeared to be stronger among never-smokers compared with current or former smokers. Conclusions/interpretation Among people with incident type 2 diabetes, pre-diagnosis BMI was positively associated with microvascular complications, while a reduced risk was observed with weight loss when compared with stable weight. The relationships with macrovascular disease were less clear. Graphical abstract


2021 ◽  
Author(s):  
Guo-Chong Chen ◽  
Rhonda Arthur ◽  
Li-Qiang Qin ◽  
Li-Hua Chen ◽  
Zhendong Mei ◽  
...  

<b>OBJECTIVE </b> <p>To evaluate associations of oily and non-oily fish consumption and fish oil supplements with incident type 2 diabetes (T2D).</p> <p><b>RESEARCH DESIGN AND METHODS </b></p> <p>We included<a> 392,287 middle-aged and older participants </a>(55.0% women) in the UK Biobank who were free of diabetes, major cardiovascular disease, and cancer, and had information on habitual intake of major food groups and use of fish oil supplements at baseline (<a>2006-2010</a>). Of these, <a>163,706</a> participated in 1-5 rounds of 24-h dietary recalls during 2009-2012. </p> <p><b>RESULTS</b></p> <p>During a median 10.1 years of follow-up, <a>7,262</a> incident cases of T2D were identified. As compared with participants who reported never consumption of oily fish, the multivariable-adjusted hazard ratios (95% CI) of T2D were 0.84 (0.78-0.91), 0.78 (0.72-0.85), and 0.78 (0.71-0.86) for those who reported <1 serving/week, weekly, and ≥2 servings/week of oily fish consumption, respectively (P-trend <0.001). Consumption of non-oily fish was not associated with risk of T2D (P-trend = 0.45). Participants who reported regular fish oil use at baseline had a 9% (95% CI: 4%-14%) lower risk of T2D as compared with non-users. Baseline regular users of fish oil who also reported fish oil use during at least one of the 24-h dietary recalls had an 18% (95% CI: 8%-27%) lower risk of T2D when compared with constant non-users.</p> <p><b>CONCLUSIONS</b></p> Our findings suggest that consumption of oily fish, but not non-oily fish, was associated with a lower risk of T2D. Use of fish oil supplements, especially constant use over time, was also associated with a lower risk of T2D.


Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Hongyu Wu ◽  
Kimberly A Bertrand ◽  
Anna L Choi ◽  
Frank B Hu ◽  
Francine Laden ◽  
...  

Background: Animal experiments have suggested that exposure to persistent organic pollutants (POPs) may lead to increased risk of type 2 diabetes. Although recent human studies supported this hypothesis, evidence from prospective investigations is sparse. Objective: To examine the associations of plasma POP concentrations with risk of incident type 2 diabetes in a prospective setting among US women. Methods: Study population was comprised of participants from two independent nested case-control studies in the Nurses’ Health Study, in which major polychlorinated biphenyl (PCB 118, 138, 153, and 180), p-p'- dichlorodiphenyldichloroethylene (DDE), dichlorodiphenyltrichloroethane (DDT), and hexachlorobenzene (HCB) were measured. A non-parametric approach was used to derive standardized scores for plasma concentrations of lipid-adjusted POPs within each study to minimize between-study variation of the POP measurements. Risk of incident type 2 diabetes during the follow-up period (1990-2008) across the tertiles of the scores was examined. Results: Of 1,120 participants, we identified 48 incident type 2 diabetes cases. After adjusting for covariates assessed at blood draw in 1990, including smoking status, body mass index, and total fish intake, plasma HCB concentration was positively associated with type 2 diabetes risk: odds ratio (OR) (95% confidence interval [CI]) was 2.77 (1.17, 6.55, P for trend =0.022) comparing the highest vs. lowest tertile. Other POPs were not significantly associated with diabetes: the ORs (95% CI) were 1.10 (0.51, 2.34, P for trend =0.81) for p-p'-DDE, 0.93 (0.44, 1.95, P for trend =0.86) for DDT, and 0.88 (0.39, 1.97, P for trend =0.76) for sum of the 4 major PCBs, comparing the extreme tertiles. Conclusion: The significant association of plasma HCB concentration with diabetes risk supports a role of POP exposure in the etiology of type 2 diabetes. More prospective data are warranted to confirm these findings.


2020 ◽  
Vol 8 (1) ◽  
pp. e001425
Author(s):  
Cornelia Then ◽  
Christina Gar ◽  
Barbara Thorand ◽  
Cornelia Huth ◽  
Holger Then ◽  
...  

IntroductionWe investigated the association of the proinsulin to insulin ratio (PIR) with prevalent and incident type 2 diabetes (T2D), components of the metabolic syndrome, and renal and cardiovascular outcomes in the population-based Cooperative Health Research in the Region of Augsburg (KORA) F4 study (2006–2008)/FF4 study (2013–2014).Research design and methodsThe analyses included 1514 participants of the KORA F4 study at baseline and 1132 participants of the KORA FF4 study after a median follow-up time of 6.6 years. All-cause and cardiovascular mortality as well as cardiovascular events were analyzed after a median time of 9.1 and 8.6 years, respectively. The association of PIR with T2D, renal and cardiovascular characteristics and mortality were assessed using logistic regression models. Linear regression analyses were used to assess the association of PIR with components of the metabolic syndrome.ResultsAfter adjustment for sex, age, body mass index (BMI), and physical activity, PIR was associated with prevalent (OR: 2.24; 95% CI 1.81 to 2.77; p<0.001) and incident T2D (OR: 1.66; 95% CI 1.26 to 2.17; p<0.001). PIR was associated with fasting glucose (β per SD: 0.11±0.02; p<0.001) and HbA1c (β: 0.21±0.02; p<0.001). However, PIR was not positively associated with other components of the metabolic syndrome and was even inversely associated with waist circumference (β: −0.22±0.03; p<0.001), BMI (β: −0.11±0.03; p<0.001) and homeostatic model assessment of insulin resistance (β: −0.22±0.02; p<0.001). PIR was not significantly associated with the intima-media thickness (IMT), decline of kidney function, incident albuminuria, myocardial infarction, stroke, cardiovascular or all-cause mortality.ConclusionsIn the KORA F4/FF4 cohort, PIR was positively associated with prevalent and incident T2D, but inversely associated with waist circumference, BMI and insulin resistance, suggesting that PIR might serve as a biomarker for T2D risk independently of the metabolic syndrome, but not for microvascular or macrovascular complications.


2020 ◽  
Vol 8 (1) ◽  
pp. e001187
Author(s):  
You-Bin Lee ◽  
Da Hye Kim ◽  
Eun Roh ◽  
So-Hyeon Hong ◽  
Jung A Kim ◽  
...  

ObjectiveVariability in estimated glomerular filtration rate (eGFR) has been associated with adverse outcomes in patients with diabetes or chronic kidney disease (CKD). However, no previous study has explored the relationship between eGFR variability and type 2 diabetes incidence.Research design and methodsIn this nationwide, longitudinal, cohort study, we investigated the association between eGFR variability and type 2 diabetes risk using the Korean National Health Insurance Service datasets from 2002 to 2017. eGFR variability was calculated using the variability independent of the mean (eGFR-VIM), coefficient of variation (eGFR-CV), standard deviation (eGFR-SD) and average real variability (eGFR-ARV).ResultsWithin 7 673 905.58 person-years of follow-up (mean follow-up: 3.19 years; n=2 402 668), 11 981 cases of incident type 2 diabetes were reported. The HRs and 95% CIs for incident type 2 diabetes increased according to advance in quartiles of eGFR-VIM (HR (95% CI): Q2, 1.068 (1.009 to 1.130); Q3, 1.077 (1.018 to 1.138); Q4, 1.203 (1.139 to 1.270)) even after adjusting for confounding factors including mean eGFR and mean fasting plasma glucose levels. The subgroup analyses according to risk factors as well as analyses using eGFR-CV, eGFR-SD and eGFR-ARV showed consistent results. The association between increased eGFR variability and type 2 diabetes risk was more prominent in men, individuals with dyslipidemia and those with CKD as shown in the subgroup analysis (p for interaction <0.001).ConclusionsIncreased eGFR variability may be an independent predictor of type 2 diabetes and might be useful for risk stratification of individuals without diabetes.


Diabetologia ◽  
2006 ◽  
Vol 50 (1) ◽  
pp. 234-236 ◽  
Author(s):  
M. B. Snijder ◽  
J. M. Dekker ◽  
L. M. Bouter ◽  
R. J. Heine ◽  
C. D. A. Stehouwer ◽  
...  

PLoS ONE ◽  
2015 ◽  
Vol 10 (11) ◽  
pp. e0141760 ◽  
Author(s):  
Ligia J. Dominguez ◽  
Maira Bes-Rastrollo ◽  
Francisco Javier Basterra-Gortari ◽  
Alfredo Gea ◽  
Mario Barbagallo ◽  
...  

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 402-402
Author(s):  
Ming-Jie Duan ◽  
Petra C Vinke ◽  
Gerjan Navis ◽  
Eva Corpeleijn ◽  
Louise Dekker

Abstract Objectives Although consumption of ultra-processed food (UPF) has previously been associated with adverse health outcomes, it is unclear how the consumption of UPF and its underlying habitual consumption patterns are associated with incident type 2 diabetes. Methods In 70 421 participants (35–70 years, 58.6% women) from the Lifelines cohort study, dietary intake was assessed with a food frequency questionnaire. Principal component analysis (PCA) was performed to derive UPF consumption patterns. UPF was related to incident diabetes with adjustments for confounders, including overall diet quality. Results During a median follow-up of 41 months, the intake of UPF was associated with higher risk of type 2 diabetes (1128 cases, OR for a 10% increment in UPF intake 1.33 [95% CI 1.26, 1.41]), and remained significant after adjustment for confounders (OR 1.25 [95% CI 1.16, 1.34]). PCA revealed four habitual UPF consumption patterns. A pattern high in cold savory snacks (OR 1.16 [95% CI 1.09, 1.22]) and a pattern high in warm savory snacks (OR 1.15 [95% CI 1.08, 1.21]) were associated with an increased diabetes risk; a pattern high in traditional Dutch cuisine was not associated with diabetes risk (OR 1.05 [95% CI 0.97, 1.14]); while a pattern high in sweet snacks and pastries was inversely associated with diabetes risk (OR 0.82 [95% CI 0.76, 0.89]). There was a clear inverse association between diabetes risk at baseline and the sweet snacks and pastries pattern (β = −0.104 [95% CI − 0.113, −0.094]). Conclusions A higher consumption of UPF was associated with higher risk of type 2 diabetes. For consumption patterns, this association was most pronounced for the patterns that were high in savory snacks. Our findings emphasize that in addition to promoting the consumption of healthy food products, discouraging the consumption of UPF, specifically savory snacks, should be considered as part of future diabetes prevention strategies. Funding Sources This project has received funding from the European Union's Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No 754425.


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