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Cathepsin D improve...
Cathepsin D improves the prediction of undetected diabetes in patients with myocardial infarction
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- Velders, Matthijs A. (author)
- Department of Medicine, Västmanland County Hospital, Västerås, Sweden,Vastmanland Cty Hosp, Dept Med, Sigtunagatan, S-72189 Vasteras, Sweden
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- Calais, Fredrik, 1971- (author)
- Örebro universitet,Institutionen för medicinska vetenskaper,Department of Cardiology,Orebro Univ, Fac Hlth, Dept Cardiol, Orebro, Sweden
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- Dahle, Nina (author)
- Uppsala universitet,Centrum för klinisk forskning Dalarna
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- Fall, Tove, 1979- (author)
- Uppsala universitet,Science for Life Laboratory, SciLifeLab,Molekylär epidemiologi
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- Hagström, Emil (author)
- Uppsala universitet,Molekylär epidemiologi,Science for Life Laboratory, SciLifeLab,Uppsala kliniska forskningscentrum (UCR)
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- Leppert, Jerzy (author)
- Uppsala universitet,Centrum för klinisk forskning, Västerås
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- Nowak, Christoph (author)
- Karolinska Institutet
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- Tenerz, Åke (author)
- Department of Medicine, Västmanland County Hospital, Västerås, Sweden,Vastmanland Cty Hosp, Dept Med, Sigtunagatan, S-72189 Vasteras, Sweden
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- Ärnlöv, Johan, 1970- (author)
- Karolinska Institutet,Högskolan Dalarna,Medicinsk vetenskap,Karolinska institutet,Karolinska Inst, Dept Neurobiol Care Sci & Soc NVS, Div Family Med & Primary Care, Huddinge, Sweden;Dalarna Univ, Sch Hlth & Social Studies, Falun, Sweden
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- Hedberg, Pär (author)
- Uppsala universitet,Centrum för klinisk forskning, Västerås,Vastmanland Cty Hosp, Dept Clin Physiol, Vasteras, Sweden
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(creator_code:org_t)
- 2019-08-20
- 2019
- English.
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In: Upsala Journal of Medical Sciences. - : Taylor & Francis. - 0300-9734 .- 2000-1967. ; 124:3, s. 187-192
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Abstract
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- Background: Newer therapeutic agents for type 2 diabetes mellitus can improve cardiovascular outcomes, but diabetes remains underdiagnosed in patients with myocardial infarction (MI). We sought to identify proteomic markers of undetected dysglycaemia (impaired fasting glucose, impaired glucose tolerance, or diabetes mellitus) to improve the identification of patients at highest risk for diabetes.Materials and methods: In this prospective cohort, 626 patients without known diabetes underwent oral glucose tolerance testing (OGTT) during admission for MI. Proximity extension assay was used to measure 81 biomarkers. Multivariable logistic regression, adjusting for risk factors, was used to evaluate the association of biomarkers with dysglycaemia. Subsequently, lasso regression was performed in a 2/3 training set to identify proteomic biomarkers with prognostic value for dysglycaemia, when added to risk factors, fasting plasma glucose, and glycated haemoglobin A1c. Determination of discriminatory ability was performed in a 1/3 test set.Results: In total, 401/626 patients (64.1%) met the criteria for dysglycaemia. Using multivariable logistic regression, cathepsin D had the strongest association with dysglycaemia. Lasso regression selected seven markers, including cathepsin D, that improved prediction of dysglycaemia (area under the receiver operator curve [AUC] 0.848 increased to 0.863). In patients with normal fasting plasma glucose, only cathepsin D was selected (AUC 0.699 increased to 0.704). Conclusions: Newly detected dysglycaemia, including manifest diabetes, is common in patients with acute MI. Cathepsin D improved the prediction of dysglycaemia, which may be helpful in the a priori risk determination of diabetes as a motivation for confirmatory OGTT.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine (hsv//eng)
Keyword
- Acute myocardial infarction
- biomarkers
- diabetes mellitus
- proteomics
- Hälsa och välfärd
Publication and Content Type
- ref (subject category)
- art (subject category)
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Velders, Matthij ...
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Calais, Fredrik, ...
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Dahle, Nina
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Fall, Tove, 1979 ...
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Hagström, Emil
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Leppert, Jerzy
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Nowak, Christoph
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Tenerz, Åke
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Ärnlöv, Johan, 1 ...
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Hedberg, Pär
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Örebro University
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Högskolan Dalarna
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Uppsala University
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Karolinska Institutet