The Synergic Association of hs-CRP and Serum Amyloid P Component in Predicting All-Cause Mortality in Patients With Type 2 Diabetes
| Autor: | Massimiliano Copetti, Monia Garofolo, Lucia Salvemini, Claudia Menzaghi, Andrea Fontana, Vincenzo Trischitta, Maria Giovanna Scarale, Giuseppe Penno, Olga Lamacchia, Salvatore De Cosmo |
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| Přispěvatelé: | Scarale, M. G., Copetti, M., Garofolo, M., Fontana, A., Salvemini, L., de Cosmo, S., Lamacchia, O., Penno, G., Trischitta, V., Menzaghi, C. |
| Rok vydání: | 2020 |
| Předmět: |
Male
Research design prediction model all-cause mortality diabetes Endocrinology Diabetes and Metabolism Type 2 diabetes Gastroenterology Cohort Studies 0302 clinical medicine Cause of Death 030212 general & internal medicine Cause of death ENFORCE Aged 80 and over biology Mortality rate Hazard ratio Middle Aged Prognosis Type 2 Diabetes Serum Amyloid P-Component RECODe hs-CRP serum amyloid P C-Reactive Protein Italy Female Cohort study Adult medicine.medical_specialty 030209 endocrinology & metabolism 03 medical and health sciences Internal medicine Diabetes mellitus Internal Medicine medicine Humans Serum amyloid P component Aged Advanced and Specialized Nursing business.industry medicine.disease Diabetes Mellitus Type 2 biology.protein business Biomarkers Diabetic Angiopathies |
| Zdroj: | Diabetes Care. 43:1025-1032 |
| ISSN: | 1935-5548 0149-5992 |
| DOI: | 10.2337/dc19-2489 |
| Popis: | OBJECTIVE Type 2 diabetes is characterized by increased death rate. In order to tackle this dramatic event, it becomes essential to discover novel biomarkers capable of identifying high-risk patients to be exposed to more aggressive preventive and treatment strategies. hs-CRP and serum amyloid P component (SAP) are two acute-phase inflammation proteins, which interact physically and share structural and functional features. We investigated their combined role in associating with and improving prediction of mortality in type 2 diabetes. RESEARCH DESIGN AND METHODS Four cohorts comprising 2,499 patients with diabetes (643 all-cause deaths) were analyzed. The improvement of mortality prediction was addressed using two well-established prediction models, namely, EstimatioN oF mORtality risk in type 2 diabetiC patiEnts (ENFORCE) and Risk Equations for Complications of Type 2 Diabetes (RECODe). RESULTS Both hs-CRP and SAP were independently associated with all-cause mortality (hazard ratios [HRs] [95% CIs]: 1.46 [1.34–1.58] [P < 0.001] and 0.82 [0.76–0.89] [P < 0.001], respectively). Patients with SAP ≤33 mg/L were at increased risk of death versus those with SAP >33 mg/L only if hs-CRP was relatively high (>2 mg/L) (HR 1.96 [95% CI 1.52–2.54] [P < 0.001] and 1.20 [0.91–1.57] [P = 0.20] in hs-CRP >2 and ≤2 mg/L subgroups, respectively; hs-CRP-by-SAP strata interaction P < 0.001). The addition of hs-CRP and SAP significantly (all P < 0.05) improved several discrimination and reclassification measures of both ENFORCE and RECODe all-cause mortality prediction models. CONCLUSIONS In type 2 diabetes, hs-CRP and SAP show opposite and synergic associations with all-cause mortality. The use of both markers, possibly in combination with others yet to be unraveled, might improve the ability to predict the risk of death in the real-life setting. |
| Databáze: | OpenAIRE |
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