Adropin Predicts Asymptomatic Heart Failure in Patients with Type 2 Diabetes Mellitus Independent of the Levels of Natriuretic Peptides
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patient Population and Study Design
2.2. Collection of Relevant Medical Data and Background Information
2.3. Echocardiographic Examination
2.4. Blood Sampling and Biomarker Analysis
2.5. Glomerular Filtration Rate and Insulin Resistance Determination
2.6. Statistics
3. Results
3.1. Spearman’s Correlations between the Levels of Biomarkers and Other Parameters
3.2. Predictors of Asymptomatic HFpEF: Univariate and Multivariate Logistic Regression Analyses
3.3. Comparison of the Predictive Models
4. Discussion
5. Study Limitations
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variables | Entire Group (n = 561) | Low-NT-proBNP Group (n = 162) | Elevated-NT-proBNP Group (n = 399) | p Value |
---|---|---|---|---|
Age (years) | 58 (47–70) | 62 (52–68) | 56 (44–69) | 0.044 |
Male/female (n (%)) | 291 (51.7)/270 (48.2) | 91 (56.2)/71 (43.8) | 200 (50.1)/45 (49.8) | 0.688 |
Diabetes duration (years) | 11.20± 6.75 | 10.40± 6.80 | 11.90± 6.33 | 0.722 |
BMI (kg/m2) | 26.90 ± 5.20 | 26.40 ± 2.70 | 27.10 ± 3.10 | 0.440 |
Waist circumference (cm) | 96.60 ± 3.60 | 99.20 ± 3.70 | 91.10 ± 3.90 | 0.160 |
WHR (units) | 0.88 ± 0.10 | 0.92 ± 0.09 | 0.84 ± 0.07 | 0.240 |
Dyslipidemia (n (%)) | 437 (77.9) | 126 (77.8) | 311 (77.0) | 0.762 |
Hypertension (n (%)) | 415 (74.0) | 124 (76.5) | 291 (72.9) | 0.430 |
Stable CAD (n (%)) | 173 (30.9) | 44 (27.1) | 129 (32.3) | 0.020 |
Atrial fibrillation (n (%)) | 95 (16.9) | 21 (12.9) | 83 (20.8) | 0.012 |
Smoking (n (%)) | 230 (41.0) | 61 (37.7) | 169 (42.4) | 0.050 |
Abdominal obesity (n (%)) | 218 (38.9) | 62 (38.3) | 156 (39.1) | 0.780 |
LVH (n (%)) | 509 (90.7) | 141 (87.0) | 368 (92.2) | 0.050 |
CKD stages 1–3 (n (%)) | 151 (29.6) | 43 (26.5) | 108 (27.1) | 0.344 |
Systolic BP (mm Hg) | 137 ± 10 | 138± 9 | 136 ± 7 | 0.780 |
Diastolic BP (mm Hg) | 84 ± 9 | 86 ± 7 | 81 ± 8 | 0.650 |
LVEDV (mL) | 153 (146–160) | 155 (139–161) | 156 (143–164) | 0.460 |
LVESV (mL) | 71 (61–80) | 73 (65–86) | 69 (62–76) | 0.058 |
LVEF (%) | 54 (51–57) | 53 (51–55) | 56 (51–59) | 0.054 |
LVMMI (g/m2) | 139 ± 14 | 145 ± 11 | 132 ± 14 | 0.071 |
LAVI (mL/m2) | 42 (35–50) | 41 (36–48) | 43 (38–49) | 0.064 |
E/e′ (units) | 16 ± 5 | 15 ± 4 | 18 ± 5 | 0.448 |
GLS (%) | −14.8 (−12.7; −15.7) | −15.3 (−12.4; −16.1) | −13.5 (−10.2; −15.7) | 0.152 |
eGFR (mL/min/1.73 m2) | 79 ± 17 | 68 ± 15 | 88 ± 11 | 0.046 |
HOMA-IR (units) | 7.12 ± 2.7 | 7.07± 2.5 | 7.30 ± 2.6 | 0.740 |
Fasting glucose (mmol/L) | 6.42 ± 1.9 | 6.30 ± 1.6 | 6.52 ± 1.7 | 0.812 |
HbA1c (%) | 6.45 ± 0.18 | 6.25 ± 0.13 | 6.50 ± 0.19 | 0.565 |
Creatinine (µmol/L) | 100.9 ± 20.1 | 94.1 ± 21.7 | 115.2 ± 30.1 | 0.640 |
SUA (mcmol/L) | 321 ± 115 | 302 ± 75 | 385 ± 925 | 0.042 |
Total cholesterol (mmol/L) | 5.98 ± 1.22 | 5.96 ± 1.20 | 6.02 ± 1.25 | 0.676 |
HDL-C (mmol/L) | 0.96 ± 0.20 | 0.99 ± 0.18 | 0.93 ± 0.20 | 0.548 |
LDL-C (mmol/L) | 3.31± 0.24 | 3.26 ± 0.21 | 3.35± 0.24 | 0.490 |
Triglycerides (mmol/L) | 1.38 ± 0.22 | 1.35 ± 0.18 | 1.41 ± 0.24 | 0.480 |
hs-CRP (mg/L) | 4.39 (1.98–6.80) | 4.02 (2.10–6.22) | 4.90 (2.25–7.22) | 0.060 |
TNF-alpha (pg/mL) | 2.70 (1.90–3.62) | 2.42 (1.69–3.15) | 2.98 (1.85–3.90) | 0.056 |
NT-proBNP (pmol/mL) | 147 (65–231) | 87 (57–113) | 188 (143–227) | 0.001 |
Adropin (ng/mL) | 3.50 (2.05–4.67) | 4.20 (3.70–4.80) | 2.40 (1.93–2.82) | 0.001 |
ACE inhibitors (n (%)) | 221 (39.4) | 48 (29.6) | 173 (43.4) | 0.042 |
Angiotensin-II receptor blockers (n (%)) | 207 (36.8) | 49 (30.2) | 158 (39.6) | 0.050 |
Beta-blockers (n (%)) | 179 (31.9) | 51 (31.4) | 128 (32.1) | 0.782 |
Ivabradine (n (%)) | 123 (21.9) | 35 (21.6) | 88 (22.1) | 0.862 |
Calcium channel blockers (n (%)) | 161 (28.7) | 45 (27.7) | 116 (29.1) | 0.438 |
Thiazide-like diuretics (n (%)) | 168 (29.9) | 42 (25.9) | 126 (31.6) | 0.124 |
Antiplatelet agents (n (%)) | 173 (30.9) | 64 (39.5) | 109 (27.3) | 0.020 |
Anticoagulants (n (%)) | 95 (16.9) | 21 (12.9) | 83 (20.8) | 0.012 |
Metformin (n (%)) | 447 (79.8) | 129 (79.6) | 318 (79.7) | 0.878 |
DPP4 inhibitors (n (%)) | 81 (14.4) | 25 (15.4) | 56 (14.0) | 0.060 |
GLP-1 receptor agonists (n (%)) | 103 (18.4) | 30 (18.5) | 73 (18.3) | 0.886 |
SGLT2 inhibitors (n (%)) | 492 (87.7) | 129 (79.6) | 363 (91.0) | 0.048 |
Statins (n (%)) | 516 (91.2) | 144 (88.9) | 372 (93.2) | 0.070 |
Variables | Dependent Variable: HFpEF | |||||||
---|---|---|---|---|---|---|---|---|
Univariate Cox Regression | Multivariate Cox Regression | |||||||
HR | 95% CI | p-Value | C-Index | HR | 95% CI | p-Value | C-Index | |
Low NT-proBNP vs. elevated NT-proBNP | 0.93 | 0.81–1.05 | 0.644 | 0.33 | - | |||
Low adropin vs. elevated adropin | 1.09 | 1.04–1.13 | 0.001 | 0.48 | 1.07 | 1.03–1.13 | 0.001 | 0.52 |
Low NT-proBNP + low adropin vs. elevated NT-proBNP | 1.12 | 1.04–2.10 | 0.001 | 0.65 | 1.10 | 1.02–2.03 | 0.001 | 0.70 |
Low NT-proBNP + elevated adropin vs. elevated NT-proBNP | 0.98 | 0.91–1.10 | 0.650 | 0.22 | - | |||
Elevated NT-proBNP + low adropin | 1.17 | 1.02–1.33 | 0.001 | 0.67 | 1.14 | 1.01–1.29 | 0.001 | 0.63 |
Elevated NT-proBNP + elevated adropin | 1.05 | 1.00–1.12 | 0.224 | 0.46 | - | |||
AF vs. non-AF | 1.05 | 1.01–1.08 | 0.044 | 0.43 | 1.05 | 1.00–1.10 | 0.064 | 0.41 |
LVH vs. non-LVH | 1.04 | 1.01–1.09 | 0.042 | 0.39 | 1.02 | 1.00–1.05 | 0.166 | 0.30 |
Administration of SGLT2i | 0.91 | 0.86–0.98 | 0.044 | 0.34 | 0.94 | 0.88–0.96 | 0.041 | 0.38 |
Predictive Models | Dependent Variable: HFpEF | |||||
---|---|---|---|---|---|---|
AUC | NRI | IDI | ||||
M (95% CI) | p Value | M (95% CI) | p Value | M (95% CI) | p Value | |
Model 1 (low adropin) | 0.802 (0.773–0.857) | - | Reference | - | Reference | - |
Model 2 (low NT-proBNP + low adropin) | 0.783 (0.722–0.853) | 0.122 | 0.28 (0.19–0.35) | 0.213 | 0.23 (0.14–0.37) | 0.426 |
Model 3 (elevated NT-proBNP + low adropin) | 0.815 (0.801–0.833) | 0.050 | 0.38 (0.22–0.51) | 0.044 | 0.29 (0.17–0.41) | 0.042 |
Model 4 (administration of SGLT2 inhibitors) | 0.791 (0.760–0.862) | 0.444 | 0.14 (0.10–0.19) | 0.668 | 0.23 (0.19–0.29) | 0.668 |
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Berezina, T.A.; Berezin, O.O.; Hoppe, U.C.; Lichtenauer, M.; Berezin, A.E. Adropin Predicts Asymptomatic Heart Failure in Patients with Type 2 Diabetes Mellitus Independent of the Levels of Natriuretic Peptides. Diagnostics 2024, 14, 1728. https://doi.org/10.3390/diagnostics14161728
Berezina TA, Berezin OO, Hoppe UC, Lichtenauer M, Berezin AE. Adropin Predicts Asymptomatic Heart Failure in Patients with Type 2 Diabetes Mellitus Independent of the Levels of Natriuretic Peptides. Diagnostics. 2024; 14(16):1728. https://doi.org/10.3390/diagnostics14161728
Chicago/Turabian StyleBerezina, Tetiana A., Oleksandr O. Berezin, Uta C. Hoppe, Michael Lichtenauer, and Alexander E. Berezin. 2024. "Adropin Predicts Asymptomatic Heart Failure in Patients with Type 2 Diabetes Mellitus Independent of the Levels of Natriuretic Peptides" Diagnostics 14, no. 16: 1728. https://doi.org/10.3390/diagnostics14161728