Diabetes and Heart Disease - Risk stratification with NT-proBNP

November is recognized as Diabetes Awareness Month, raising attention about diabetes and the importance of prevention and management of the disease that impacts millions of people worldwide.

Diabetes and Heart Disease – Risk stratification with NT-proBNP

Diabetes and heart disease are closely linked and patients suffering from diabetes have a 2- to 4 fold increased risk for developing cardiovascular diseases (CVD)  and concomitant heart failure (HF). Furthermore, HF patients with diabetes mellitus (DM) have a worse prognosis that those patients without DM (1, 2). In individuals with type 2 diabetes, high blood sugar levels and insulin resistance can lead to inflammation and atherosclerosis, a disease where arteries narrow, increasing the risk of CVD. Altered blood sugar levels are often associated with other CV risk factors, such as hypertension and obesity (3).

Diabetes and Heart Disease – Risk stratification with NT-proBNP 

Identifying patients who are at risk in developing HF remains a clinical challenge. Assessing the risk of HF development in patients with diabetes is important and the use of biomarkers could be beneficial (4). NT-proBNP, a protein that is specifically secreted by cardiac cells, is the “gold standard” biomarker for heart failure (5, 6). In patients with type 2 diabetes, NT-proBNP has been shown to predict death and cardiovascular events (7, 8). Moreover, a recent study investigated the relationships of NT-proBNP with the risk of developing diabetes and diabetes-related complication in initially healthy individuals (9). NT-pro BNP levels were measured in blood samples in a large cohort (European Prospecive Investigation Into Cancer and Nutrition) of over 27,000 individuals. The study demonstrated that NT-proBNP concentrations were inversely associated with the risk of type 2 diabetes in healthy individuals. Higher NT-proBNP levels are related to a higher risk of vascular disease in people who develop the disease. The authors conclude that NT-proBNP may be a promising biomarker to identify asymptomatic individuals who are at high risk developing diabetes independent of potential confounders.

NT-proBNP can be reliably measured in SERUM & PLASMA with a conventional ELISA assay.

NT-proBNP ELISA assay highlights (cat. no. SK-1204)

• RELIABLE – CE marked  –  for IVD use in the EU
• FLEXIBLE & EASY–  can be run in every lab
• CONVENIENT – Two controls included
• Assay independently validated in saliva samples
• Proficiency tested in accredited laboratory program Proficiency Testing Certificate 

 

Example of a BIOMEDICA ELISA assay test kit.

NT-proBNP ELISA (#SK-1204) click here for more information

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NT-proANP ELISA (cat. no. BI-20892) – for human and rodent samples (10µl sample volume)

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Literature

1. Epidemiology, Pathophysiology, Diagnosis and Treatment of Heart Failure in Diabetes. Park JJ. Diabetes Metab J. 2021 Mar;45(2):146-157. doi: 10.4093/dmj.2020.0282. Epub 2021 Mar 25. Erratum in: Diabetes Metab J. 2021 Sep;45(5):796. PMID: 33813813; PMCID: PMC8024162.
2. Diabetes as a risk factor for heart failure in women and men: a systematic review and meta-analysis of 47 cohorts including 12 million individuals. Ohkuma T, Komorita Y, Peters SAE, Woodward M. Diabetologia. 2019 Sep;62(9):1550-1560. doi: 10.1007/s00125-019-4926-x. Epub 2019 Jul 18. PMID: 31317230; PMCID: PMC6677875.
3. Diabetes leading to heart failure and heart failure leading to diabetes: epidemiological and clinical evidence. Palazzuoli A, Iacoviello M. Heart Fail Rev. 2023 May;28(3):585-596. doi: 10.1007/s10741-022-10238-6. Epub 2022 May 6. PMID: 35522391; PMCID: PMC10140137.
4. Assessing Cardiovascular Risk in Patients with Diabetes: An Update. Damaskos C, Garmpis N, Kollia P, Mitsiopoulos G, Barlampa D, Drosos A, Patsouras A, Gravvanis N, Antoniou V, Litos A, Diamantis E. Curr Cardiol Rev. 2020;16(4):266-274. doi: 10.2174/1573403X15666191111123622. PMID: 31713488; PMCID: PMC7903509.
5. NT-proBNP: The Gold Standard Biomarker in Heart Failure. McKie PM, Burnett JC Jr. J Am Coll Cardiol. 2016 Dec 6;68(22):2437-2439. doi: 10.1016/j.jacc.2016.10.001. PMID: 27908348.
6. 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Heidenreich PA, Bozkurt B, Aguilar D, Allen LA, Byun JJ, Colvin MM, Deswal A, Drazner MH, Dunlay SM, Evers LR, Fang JC, Fedson SE, Fonarow GC, Hayek SS, Hernandez AF, Khazanie P, Kittleson MM, Lee CS, Link MS, Milano CA, Nnacheta LC, Sandhu AT, Stevenson LW, Vardeny O, Vest AR, Yancy CWCirculation. 2022 May 3;145(18):e876-e894. doi: 10.1161/CIR.0000000000001062. Epub 2022 Apr 1. PMID: 35363500.
7. NT-proBNP as a predictor of death and cardiovascular events in patients with type 2 diabetes. Malachias MVB, Wijkman MO, Bertoluci MC. Diabetol Metab Syndr. 2022 May 3;14(1):64. doi: 10.1186/s13098-022-00837-6. PMID: 35501909; PMCID: PMC9063067.
8. The role of NT-proBNP in the evaluation of diabetic patients with heart failure. Fringu FI, Sitar-Taut AV, Caloian B, Zdrenghea D, Comsa D, Gusetu G, Pop D. Acta Endocrinol (Buchar). 2020 Apr-Jun;16(2):183-191. doi: 10.4183/aeb.2020.183. PMID: 33029235; PMCID: PMC7535893.
9. Opposing Associations of NT-proBNP With Risks of Diabetes and Diabetes-Related Complications. Birukov A, Eichelmann F, Kuxhaus O, Polemiti E, Fritsche A, Wirth J, Boeing H, Weikert C, Schulze MB. Diabetes Care. 2020 Dec;43(12):2930-2937. doi: 10.2337/dc20-0553. Epub 2020 Aug 17. PMID: 32816995; PMCID: PMC7770272.