Simple blood test may predict future heart, kidney risk for diabetics

NEW YORK: A simple blood test may predict the risk of progressive heart and kidney disease in people with type 2 diabetes, according to new research.

An analysis of a clinical trial of more than 2,500 people with type 2 diabetes and kidney disease has found that high levels of four biomarkers in blood tests are strongly predictive for the development of heart and kidney issues, according to the study published in the American Heart Association’s flagship journal Circulation.

“High levels of certain biomarkers are indicators of heart and kidney complications and may help predict future risk of disease progression,” said lead author James Januzzi from Harvard Medical School, also a cardiologist at the Massachusetts General Hospital.

People who took canagliflozin, a sodium glucose co-transporter 2 inhibitor (SGLT2 inhibitor), had lower levels of the four biomarkers compared to those who took a placebo over the three-year study period.

Canagliflozin is a third-line medication to be tried after metformin, a first-line medication for type 2 diabetes.

Treatment with canagliflozin helped to substantially reduce the risk of hospitalisation for heart failure and other heart complications among patients considered to have the highest risk.

The researchers analysed biomarker data from the blood samples of 2,627 people to assess the effects of canagliflozin on concentrations of the four biomarkers. Patients were separated into low, medium and high risk categories. People at highest risk showed dramatically higher rates of progressive kidney failure and cardiovascular complications throughout the three-year study period.

The analysis found high concentrations of each biomarker at the beginning of the study were strongly predictive of the severity of the participant’s heart and kidney issues.The concentrations of each of the four biomarkers in people taking canagliflozin were lower after one year and three years compared to those taking the placebo.

After one year, the levels of all biomarkers in participants who took canagliflozin rose 3 per cent to 10 per cent, compared to an increase of 6 per cent to 29 per cent in those who took the placebo.

“It was reassuring to discover that canagliflozin helped reduce risks the most in people with the highest chances for complications. Future studies are needed to better understand how type 2 diabetes in conjunction with kidney disease develops and progresses so that we may initiate life-saving therapies earlier, before symptoms of heart and kidney disease have occurred.” Januzzi said.