Simple Blood Test Predicts Risk of Heart and Kidney Disease in Diabetics

Medical professionals routinely assess biomarkers to screen, diagnose, or manage specific health conditions. Prior investigations have indicated that levels of certain biomarkers might predict the onset and advancement of chronic kidney disease and cardiovascular events in individuals with Type 2 diabetes. Now, an analysis of a clinical trial involving over 2,500 people affected by Type 2 diabetes and kidney disease has revealed that elevated levels of four biomarkers hold strong potential for predicting heart and kidney issues. This discovery could pave the way for a simple blood test to predict the risk of progressive heart and kidney problems in individuals with both Type 2 diabetes and kidney disease.

Researchers at Harvard Medical School (Boston, MA, USA) examined biomarker data from blood samples collected from 2,627 participants in the Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation (CREDENCE) trial. The trial assessed the effects of canagliflozin, a sodium glucose co-transporter 2 inhibitor (SGLT2 inhibitor), on concentrations of four biomarkers at the study's start, one-year mark, and three-year mark. The four biomarkers were N-terminal pro–B-type natriuretic peptide, high-sensitivity cardiac troponin T, growth differentiation factor-15, and insulin-like growth factor binding protein 7. The researchers also explored each biomarker's prognostic value for varying degrees of kidney issues and the risk of death attributed to kidney disease or cardiovascular disease.

Image: Four biomarkers are strongly predictive for development of heart and kidney issues in Type 2 diabetics (Photo courtesy of American Heart Association)

Participants were categorized as low, medium, or high risk. The analysis revealed those categorized as high risk exhibited significantly higher rates of progressive kidney failure and cardiovascular complications throughout the three-year duration of the study. The researchers found that elevated concentrations of each biomarker at the study's outset strongly correlated with the severity of heart and kidney problems among the participants. Notably, individuals taking canagliflozin displayed lower concentrations of each biomarker after one year and three years, in comparison to those taking a placebo. After one year, biomarker levels in canagliflozin recipients increased by 3% to 10%, whereas placebo recipients experienced an increase of 6% to 29%.

“High levels of certain biomarkers are indicators of heart and kidney complications and may help predict future risk of disease progression,” said lead author James Januzzi, M.D., the Hutter Family Professor of Medicine at Harvard Medical School. “Treatment with canagliflozin, a sodium glucose co-transporter 2 inhibitor, lowered biomarker levels and reduced the risk of hospitalization for heart failure and other heart complications in people at the highest risk.”

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