Division of Nephrology, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Fatih, 34360, Istanbul, Turkey.
Division of Rheumatology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
Acta Diabetol. 2023 Aug;60(8):1027-1036. doi: 10.1007/s00592-023-02095-y. Epub 2023 Apr 21.
In this study, we aimed to demonstrate the effectiveness of serum amino-terminal proCNP (NT-proCNP) levels in predicting coronary heart disease (CHD) and cardiovascular risk in type 2 diabetes mellitus (T2DM) patients.
We recruited 73 patients with T2DM in the study. Additionally, we grouped the patients according to their status of diabetic retinopathy (DR) as no DR, non-proliferative DR, or proliferative DR. Serum NT-proCNP levels of the patients were measured and their atherosclerotic cardiovascular disease (ASCVD) risk scores were calculated.
There was no significant difference in terms of NT-proCNP levels between the groups (p = 0.3) and in terms of CHD and ASCVD risk scores (p = 0.4 and p = 0.4, respectively). In the correlation analysis, a significant correlation was observed between the NT-proCNP levels and the ASCVD risk score (r = 0.373; p = 0.008 among the entire cohort and r = 0.555; p = 0.01 in the non-proliferative-DR group), smoking status (r = 0.280; p = 0.03 among the entire cohort and r = 0.362; p = 0.035 in the non-proliferative-DR group), sBP (r = 0.278; p = 0.038 among the entire cohort), and dBP (r = 0.284; p = 0.034 among the entire cohort and r = 0.482; p = 0.004 in the proliferative-DR group). In the ROC analysis, we found that the NT-proCNP level predicted a high ASCVD risk score with 83.3% sensitivity and 70.8% specificity and a very high ASCVD risk score with 100% sensitivity and 69.2% specificity among the proliferative-DR patients. No cut-off value was calculated for the prediction of high and very-high ASCVD risk scores in patients with non-proliferative DR. Similarly, no cut-off value was revealed for the prediction of established coronary artery disease in all groups.
Our study revealed a significant association between NT-proCNP levels and high ASCVD risk scores in patients with proliferative DR.
本研究旨在证明血清氨基末端 proCNP(NT-proCNP)水平在预测 2 型糖尿病(T2DM)患者冠心病(CHD)和心血管风险方面的有效性。
我们招募了 73 名 T2DM 患者进行研究。此外,我们根据患者的糖尿病视网膜病变(DR)状况将其分为无 DR、非增殖性 DR 和增殖性 DR。测量患者的血清 NT-proCNP 水平并计算其动脉粥样硬化性心血管疾病(ASCVD)风险评分。
各组之间 NT-proCNP 水平无显著差异(p=0.3),CHD 和 ASCVD 风险评分也无显著差异(p=0.4 和 p=0.4)。在相关性分析中,NT-proCNP 水平与 ASCVD 风险评分之间存在显著相关性(整个队列中 r=0.373;p=0.008,非增殖性 DR 组中 r=0.555;p=0.01),与吸烟状况(整个队列中 r=0.280;p=0.03,非增殖性 DR 组中 r=0.362;p=0.035),收缩压(整个队列中 r=0.278;p=0.038)和舒张压(整个队列中 r=0.284;p=0.034)。在 ROC 分析中,我们发现 NT-proCNP 水平在增殖性 DR 患者中预测 ASCVD 高风险评分的敏感性为 83.3%,特异性为 70.8%,预测 ASCVD 极高风险评分的敏感性为 100%,特异性为 69.2%。对于非增殖性 DR 患者的 ASCVD 高风险评分和极高风险评分的预测,未计算出截断值。同样,对于所有组中已确诊的冠状动脉疾病的预测,也未揭示出截断值。
我们的研究表明,在增殖性 DR 患者中,NT-proCNP 水平与 ASCVD 高风险评分之间存在显著关联。