According to research published in the Journal of Translational Medicine, researchers reported that they have discovered a blood test that could potentially be used to assess a patient’s risk of type 2 diabetes (T2D). Currently, high-sensitivity C-reactive protein (CRP) is the most common inflammatory biomarker used to predict the risk of T2D; however, researchers from Edith Cowan University in Australia reported the “that joint assessment of biomarkers, rather than assessing each individually” would improve the chances of predicting complications of both the risk of diabetes risk and those of the disease itself.
According to lead author Dan Wu, who is affiliated with the Department of Endocrinology at the First Affiliated Hospital of Shantou University Medical College, and colleagues, the researchers wanted to examine the predictive value of the association between systemic inflammation by jointly assessed cumulative high-sensitivity CRP (CumCRP) and monocyte to high-density lipoprotein ratio (CumMHR) for T2D in the general population.
Regarding study outcomes, Dr. Wu said, “…increases in the MHR [monocyte to high-density lipoprotein ratio] in each CRP stratum increased the risk of type 2 diabetes; concomitant increases in MHR and CRP presented significantly higher incidence rates and risks of diabetes.” Dr. Wu added, “Furthermore, the association between chronic inflammation (reflected by the joint cumulative MHR and CRP exposure) and incident diabetes was highly age- and sex-specific and influenced by hypertension, high cholesterol, or prediabetes. The addition of the MHR and CRP to the clinical risk model significantly improved the prediction of incident diabetes.”
Regarding the study’s importance, Dr. Wu noted, “Epidemiological evidence indicates a consistent increase in early-onset diabetes, especially in developing countries. Leveraging this age-specific association between chronic inflammation and type 2 diabetes may be a promising method for achieving early identification of at-risk young adults and developing personalized interventions.”
The researchers evaluated 40,813 subjects without diabetes from a prospective real-life cohort from the Kailuan Study in China who were followed every other year for 10 years starting in 2010 until December 2020. Conducting multivariable Cox regression analyses, they evaluated the adjusted hazard ratios (aHRs) of incident diabetes and found that during a median follow-up of 7.98 (interquartile range, 5.74-8.87) years, 4,848 T2D cases developed. CumMHR and CumCRP were alone or jointly associated with incident T2D, and elevated CumMHR levels significantly increased the risk of incident diabetes in each group with CumCRP (P-interaction = .0278).
Subjects with elevations in both CumMHR and CumCRP levels had the highest risk (aHR, 1.71; 95% CI, 1.52-1.91) compared with both in the lower groups with lower risk. The authors highlighted that the concomitant risks associated T2D was modified by age, sex, hypertension, dyslipidemia, and prediabetes status, with risks increasing from 0.7377 to 0.7417 when CumMHR and CumCRP were added into the multivariable-adjusted statistical model and percent reclassification of improvement (%) of 12.39 (9.39-15.37; P <.0001).
The authors concluded that MHR and hsCRP were both independently and jointly associated with an increased risk of T2D and, additionally, that adding them to established risk factors may improve a potential reclassification of diabetes as well as a risk-prediction diagnosis.
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