Posted on 01/30/2024 1:48:25 PM PST by nickcarraway
An international academic consortium has identified 13 biomarkers that significantly improve the ability to accurately predict cardiovascular disease risk in people with type 2 diabetes. The analysis, conducted by 23 experts from 11 countries, was led by The Johns Hopkins University in the United States, the Chinese University of Hong Kong in Hong Kong, and Lund University in Sweden.
Although people with type 2 diabetes are two times more likely to develop cardiovascular disease than those without diabetes, it is a challenge for clinicians to predict who in this population is most at risk. Traditional risk scores, which reflect risk level in the presence of certain risk factors, have become dated and do not perform well in diverse populations.
More than 500 million people worldwide live with diabetes. With numbers that high, it's important to identify readily available ways to accurately classify patients so that those at higher risk of cardiovascular disease can receive the preventative care they need."
Maria F. Gomez, Ph.D., co-senior author of the analysis, research group leader at the Lund University Diabetes Centre and professor of physiology at Lund University
With this in mind, the research team reviewed and analyzed medical studies published from the year 1990 onward that investigated the differences between people with type 2 diabetes who experienced cardiovascular disease and those who did not.
"Our goal was to identify promising markers that could improve cardiovascular risk prediction in people with type 2 diabetes," says Nestoras Mathioudakis, M.D., M.H.S., co-senior author of the analysis, co-medical director of the Johns Hopkins Medicine Diabetes Prevention & Education Program, and an associate professor of medicine at the Johns Hopkins University School of Medicine. "We wanted to look beyond traditional prognostic factors like hypertension and smoking."
SLAS EU - Highlights from 2022 eBook Compilation of the top interviews, articles, and news in the last year. Download the latest edition From their review and analysis of the published medical literature, the team extracted data on 321 biomarkers and found that 13 were significantly associated with cardiovascular risk in people with type 2 diabetes. The standout biomarker was N-terminal pro b-type natriuretic peptide (NT-proBNP), which is currently used to monitor heart failure status in patients. The team found that, across several studies, higher levels of NT-proBNP in the body correlated with a higher risk of cardiovascular disease. One study of 16,000 patients that the team reviewed found a 64% hazard rate increase for every standard deviation increase of NT-proBNP.
"The 13 biomarkers, especially NT-proBNP, warrant further testing to evaluate their potential," says Ronald Ma, M.B. B.Chir., FRCP, FHKCP, FHKAM, co-senior author of the analysis and S.H. Ho Professor of Diabetes at the Chinese University of Hong Kong. "If future studies confirm their value in predicting cardiovascular risk in patients with type 2 diabetes, we may be able to change standards of care."
The study was conducted as part of the Precision Medicine in Diabetes Initiative, an international partnership between the American Diabetes Association and the European Association for the Study of Diabetes.
The analysis was published Jan. 22 in Communications Medicine.
Source:
Johns Hopkins Medicine
Journal reference: Ahmad, A., et al. (2024). Precision prognostics for cardiovascular disease in Type 2 diabetes: a systematic review and meta-analysis. Communications Medicine. doi.org/10.1038/s43856-023-00429-z.
Ping
Yes...I'm just that cynical.
I'll speak with my doctor about it next month...whom I trust quite well to cut through the BS. He thinks much like I do.
He's even asked me if I'd like to borrow his AR-15 to try if I'm thinking of getting one. I call him Dr. Ted. He likes it.
The trick is to eliminate the risk.
Type II Diabetes is self induced and in most cases can be reversed as well as a lot of other associated problems. This is an oldie but a goodie from KD:
Once again, for those who missed it the last time, here’s the “don’t eat” list:
Anything with added sugars on the label irrespective of amount. If a word ending in “-ose” is on the label, it’s a sugar. Maltrose, dextrose, sucrose, fructose, etc. All are sugars. Go through your cupboard and throw all those packages and cans out, and don’t buy any more of them.
Anything with man-made PUFAs in it. There are two basic types of PUFAs — Omega-3 and Omega-6. Omega-3 is good for you in reasonable amounts and is almost-exclusively found in the flesh of animals, including most-especially fish. Omega-6, on the other hand, is found naturally in most plant material. The problem is that the amount found in plants you eat whole is tiny but when concentrated into man-extracted oils from vegetable sources you wind up consuming thousands of times more of it than you ever could by eating the actual plant. Cottonseed oil, for example, is full of this stuff, yet you’d never sit down and eat a bowl of cotton seeds! Likewise, you’d have to eat something like two bushels of corn in a single sitting to get the amount of PUFA found in one tablespoon of corn oil, but it is utterly trivial to consume that amount in baked goods. This is true for all vegetable oils. The only exception? Small amounts of olive oil are reasonable used as a salad dressing. But you should never, ever, cook with vegetable oils including sauteeing, frying, basting or similar because the fact that they’re unsaturated means they oxidize rapidly and heat makes them oxidize more and faster. The “switch” to vegetable-based oils in fryers has probably killed more Americans in the last 40 years than all other causes of death combined. By the way, if you want the worst of the worst they come in the form of anything that has the word “hydrogenated” on the label. Those are PUFAs that have been chemically stabilized so they are a solid and don’t spoil while on the shelf in the store. Let me be crystal-clear: The amount of PUFA you can safely ingest, and thus should ingest, is zero, with the exception of room-temperature olive oil used as a salad dressing or similar. That section in your grocery store is IMHO “heart attack in a bottle.”
“White”, starchy vegetables and plants. This means rice, potatoes and similar. Rice and potatoes are peasant food. If you’d otherwise die they’re acceptable, I guess, but I’d hardly call them my first choice. Rice I’ve already covered but potatoes aren’t far behind. Their nutrient balance is severely skewed and, frankly, sucks. With 63g of carbs and 278 calories in one large (300gm) potato, while they have a decent amount of fiber (7g) and a good protein balance the rest is lacking. Of the vitamin complex only C and B6 are well-represented, and only half of your needs (compare against Broccoli.) The real problem with starchy foods is that they’re carb-dense but nutrient-poor on balance which means they’re not only incompatible with low-carb eating they will probably crowd out the nutrient-dense vegetables you should eat. Since these tend to digest quickly they also provoke a large insulin response. Note that any of these fried in PUFAs, such as french fries, dramatically multiply the trouble. These “foods” are served in restaurants (e.g. xxx “over rice” or xxx “with fries”) because on a per-calorie basis they cost almost nothing.
Grains (especially wheat) and anything made with them. Cereals and similar are even worse than starchy vegetables in that the fiber is nearly-all absent as processed and thus has to be added back. Whole-wheat bread has a horrible protein quality score, is very high in carbs with 2 slices having 24g all on its own (20 of which “count” as there are 4 of fiber) and a modest nutrient balance. Store-bought breads and cereals, however, almost all contain hydrogenated oils — that is, the worst sort of PUFAs. In terms of insulin response grains are almost-indistinguishable from table sugar and some are actually worse. Yes, this means no pizzas, pastas and similar. Again, the reason that hamburger comes on a bun at the restaurant or drive-thru is because on a per-calorie basis it costs pennies; to get the same calories with that burger wrapped in lettuce you’d need another patty that contains actual food.
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