Precision prognostics for cardiovascular disease in Type 2 diabetes: a systematic review and meta-analysis

作者全名："Ahmad, Abrar; Lim, Lee-Ling; Morieri, Mario Luca; Tam, Claudia Ha-ting; Cheng, Feifei; Chikowore, Tinashe; Dudenhoffer-Pfeifer, Monika; Fitipaldi, Hugo; Huang, Chuiguo; Kanbour, Sarah; Sarkar, Sudipa; Koivula, Robert Wilhelm; Motala, Ayesha A.; Tye, Sok Cin; Yu, Gechang; Zhang, Yingchai; Provenzano, Michele; Sherifali, Diana; de Souza, Russell J.; Tobias, Deirdre Kay; Gomez, Maria F.; Ma, Ronald C. W.; Mathioudakis, Nestoras"

作者地址："[Ahmad, Abrar; Dudenhoffer-Pfeifer, Monika; Fitipaldi, Hugo] Lund Univ, Diabet Ctr, Dept Clin Sci, Malmo, Sweden; [Lim, Lee-Ling] Univ Malaya, Fac Med, Dept Med, Kuala Lumpur, Malaysia; [Lim, Lee-Ling; Tam, Claudia Ha-ting; Huang, Chuiguo; Yu, Gechang; Zhang, Yingchai; Ma, Ronald C. W.] Chinese Univ Hong Kong, Dept Med & Therapeut, Hong Kong, Peoples R China; [Lim, Lee-Ling] Asia Diabet Fdn, Hong Kong, Peoples R China; [Morieri, Mario Luca] Univ Hosp Padova, Metab Dis Unit, Padua, Italy; [Morieri, Mario Luca] Univ Padua, Dept Med, Padua, Italy; [Tam, Claudia Ha-ting; Yu, Gechang; Zhang, Yingchai; Ma, Ronald C. W.] Chinese Univ Hong Kong, Li Ka Shing Inst HealthSciences, Lab Mol Epidemiol Diabet, Hong Kong, Peoples R China; [Tam, Claudia Ha-ting; Huang, Chuiguo; Yu, Gechang; Zhang, Yingchai; Ma, Ronald C. W.] Chinese Univ Hong Kong, Hong Kong Inst Diabet & Obes, Hong Kong, Peoples R China; [Cheng, Feifei] Chongqing Med Univ, Affiliated Hosp 2, Hlth Management Ctr, Chongqing, Peoples R China; [Chikowore, Tinashe] Univ Witwatersrand, Fac Hlth Sci, Dept Paediat, MRC Wits Dev Pathways Hlth Res Unit, Johannesburg, South Africa; [Chikowore, Tinashe] Univ Witwatersrand, Sydney Brenner Inst Mol Biosci, Fac Hlth Sci, Johannesburg, South Africa; [Kanbour, Sarah] AMAN Hosp, Doha, Qatar; [Sarkar, Sudipa; Mathioudakis, Nestoras] Johns Hopkins Univ, Sch Med, Dept Med, Baltimore, MD 21218 USA; [Koivula, Robert Wilhelm] Univ Oxford, Oxford Ctr Diabet Endocrinol & Metab, Oxford, England; [Motala, Ayesha A.] Univ KwaZulu Natal, Nelson R Mandela Sch Med, Dept Diabet & Endocrinol, Durban, South Africa; [Tye, Sok Cin] Univ Med Ctr Groningen, Dept Clin Pharm & Pharmacol, Groningen, Netherlands; [Tye, Sok Cin] Harvard Med Sch, Joslin Diabet Ctr, Sect Genet & Epidemiol, Boston, MA USA; [Provenzano, Michele] Univ Bologna, Nephrol Dialysis & Renal Transplant Unit, IRCCS Azienda Osped Univ Bologna, Alma Mater Studiorum, Bologna, Italy; [Sherifali, Diana] McMaster Univ, Heather M Arthur Populat Hlth Res Inst, Hamilton, ON, Canada; [de Souza, Russell J.] McMaster Univ, Fac Hlth Sci, Dept Hlth Res Methods Evidence & Impact, Hamilton, ON, Canada; [de Souza, Russell J.] Hamilton Hlth Sci Corp, Populat Hlth Res Inst, Hamilton, ON, Canada; [Tobias, Deirdre Kay] Harvard TH Chan Sch Publ Hlth, Boston, MA USA; [Gomez, Maria F.] Aarhus Univ, Fac Hlth, Aarhus, Denmark"

通信作者："Ma, RCW (通讯作者)，Chinese Univ Hong Kong, Dept Med & Therapeut, Hong Kong, Peoples R China.; Ma, RCW (通讯作者)，Chinese Univ Hong Kong, Li Ka Shing Inst HealthSciences, Lab Mol Epidemiol Diabet, Hong Kong, Peoples R China.; Ma, RCW (通讯作者)，Chinese Univ Hong Kong, Hong Kong Inst Diabet & Obes, Hong Kong, Peoples R China.; Mathioudakis, N (通讯作者)，Johns Hopkins Univ, Sch Med, Dept Med, Baltimore, MD 21218 USA.; Gomez, MF (通讯作者)，Aarhus Univ, Fac Hlth, Aarhus, Denmark."

来源：COMMUNICATIONS MEDICINE

ESI学科分类：　

WOS号：WOS:001150686900001

JCR分区：　

影响因子：　

年份：2024

卷号：4

期号：1

开始页：　

结束页：　

文献类型：Article

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摘要："BackgroundPrecision medicine has the potential to improve cardiovascular disease (CVD) risk prediction in individuals with Type 2 diabetes (T2D).MethodsWe conducted a systematic review and meta-analysis of longitudinal studies to identify potentially novel prognostic factors that may improve CVD risk prediction in T2D. Out of 9380 studies identified, 416 studies met inclusion criteria. Outcomes were reported for 321 biomarker studies, 48 genetic marker studies, and 47 risk score/model studies.ResultsOut of all evaluated biomarkers, only 13 showed improvement in prediction performance. Results of pooled meta-analyses, non-pooled analyses, and assessments of improvement in prediction performance and risk of bias, yielded the highest predictive utility for N-terminal pro b-type natriuretic peptide (NT-proBNP) (high-evidence), troponin-T (TnT) (moderate-evidence), triglyceride-glucose (TyG) index (moderate-evidence), Genetic Risk Score for Coronary Heart Disease (GRS-CHD) (moderate-evidence); moderate predictive utility for coronary computed tomography angiography (low-evidence), single-photon emission computed tomography (low-evidence), pulse wave velocity (moderate-evidence); and low predictive utility for C-reactive protein (moderate-evidence), coronary artery calcium score (low-evidence), galectin-3 (low-evidence), troponin-I (low-evidence), carotid plaque (low-evidence), and growth differentiation factor-15 (low-evidence). Risk scores showed modest discrimination, with lower performance in populations different from the original development cohort.ConclusionsDespite high interest in this topic, very few studies conducted rigorous analyses to demonstrate incremental predictive utility beyond established CVD risk factors for T2D. The most promising markers identified were NT-proBNP, TnT, TyG and GRS-CHD, with the highest strength of evidence for NT-proBNP. Further research is needed to determine their clinical utility in risk stratification and management of CVD in T2D. People living with type 2 diabetes (T2D) are more likely to develop problems with their heart or blood circulation, known as cardiovascular disease (CVD), than people who do not have T2D. However, it can be difficult to predict which people with T2D are most likely to develop CVD. This is because current approaches, such as blood tests, do not identify all people with T2D who are at an increased risk of CVD. In this study we reviewed published papers that investigated the differences between people with T2D who experienced CVD compared to those who did not. We found some indicators that could potentially be used to determine which people with T2D are most likely to develop CVD. More studies are needed to determine how useful these are. However, they could potentially be used to enable clinicians to provide targeted advice and treatment to those people with T2D at most risk of developing CVD. Ahmad, Lim, Morieri, Tam et al perform a systematic review and meta-analysis of biomarkers, genetic markers, and risk scores for prediction of cardiovascular outcomes in Type 2 diabetes. A few prognostic markers are identified that provide incremental predictive utility beyond established cardiovascular risk factors."

基金机构："Swedish Heart-Lung Foundation; Swedish Research Council (EXODIAB); Swedish Foundation for Strategic Research (LUDC-IRC); EU H2020-JTI-lMl2-2015-05; UK Medical Research Council Population and Systems Medicine Board; Italian Ministry of Health Grant ""Ricerca Finalizzata 2019"" [20190470]; Research Grants Council of the Hong Kong Special Administrative Region [2009-1039, 2018-02837]; Croucher Foundation Senior Medical Research Fellowship [15-0067]; University Grants Committee Research Grants Matching Scheme [115974]; Research Committee Postdoctoral Fellowship Scheme of the Chinese University of Hong Kong [IF048-2022]; Second Affiliated Hospital of Chongqing Medical University [GR-2019-12369702]; Wellcome Trust [CU R4012-18]; Novo Nordisk Foundation; Chinese University of Hong Kong; Lund University; National Institute of Diabetes and Digestive and Kidney Diseases [2022cffkyqdj]; [214205/Z/18/Z]; [NNF18OC0031650]; [R01DK125780]; [R01DK134955]"

基金资助正文："A.A., M.D-P., H.F., M.F.G. acknowledge support from the Swedish Heart-Lung Foundation (20190470), Swedish Research Council (EXODIAB, 2009-1039; 2018-02837), Swedish Foundation for Strategic Research (LUDC-IRC, 15-0067), EU H2020-JTI-lMl2-2015-05 (Grant agreement number 115974 - BEAt-DKD) to M.F.G. L-L.L. acknowledge UK Medical Research Council Population and Systems Medicine Board (IF048-2022). M.L.M. is supported by Italian Ministry of Health Grant ""Ricerca Finalizzata 2019"" - GR-2019-12369702. C.H.T.T., C.H, and R.C.W.M. acknowledge support from the Research Grants Council of the Hong Kong Special Administrative Region (CU R4012-18), the Croucher Foundation Senior Medical Research Fellowship, University Grants Committee Research Grants Matching Scheme and Research Committee Postdoctoral Fellowship Scheme of the Chinese University of Hong Kong. F.F.C. acknowledge the Second Affiliated Hospital of Chongqing Medical University (No. 2022cffkyqdj). T.C. is an international training fellow supported by the Wellcome Trust grant (214205/Z/18/Z). R.W.K. was funded by a Novo Nordisk Foundation (NNF18OC0031650) postdoctoral fellowship. G.Y. and R.C.W.M. acknowledges support from the Provost's Scheme for PhD scholarship from the Chinese University of Hong Kong. Y.Z. acknowledges a Postgraduate Studentship and Vice-Chancellor's PhD scholarship from the Chinese University of Hong Kong. The authors wish to acknowledge the support of librarians from Lund University, Maria Bjorklund and Krister Aronsson for their expert support with the literature search. N.M. is supported by grants from the National Institute of Diabetes and Digestive and Kidney Diseases (R01DK125780, R01DK134955)."