Biomarkers found to reveal cardiovascular disease risk in people with subject 2 diabetes

An international research team led by the University of Lund (Sweden) with the participation of the research center in Nutrition at the University of Navarra has identified epigenetic biomarkers that can predict which people with subject 2 diabetes are at risk of developing cardiovascular disease. The results of the study have just been published in the journal Cell Reports Medicine.

"People with subject 2 diabetes are up to four times more likely to suffer heart attacks, strokes, angina and other coronary heart disease than healthy people. Therefore, biomarkers are needed to help us understand which individuals are most at risk of being affected," explains Sonia García Calzón, first author of the article and researcher at the research center in Nutrition and the Physiopathology of Obesity and Nutrition area of the CIBER (CIBEROBN).

To do this, the team of scientists conducted cardiovascular follow-up of 752 people who, at the start of the study, had recently been diagnosed with subject 2 diabetes. None of the participants - from the ANDIS ("All New Diabetics in Skåne") diabetes cohort - had previously suffered from major cardiovascular disease. During more than seven years of follow-up, 102 of them suffered major cardiovascular complications.

"By studying chemical changes in the participants' genomes, called DNA methylation, we wanted to identify epigenetic biomarkers that could predict cardiovascular disease. DNA methylation controls which genes are active or inactive in our cells, and when this mechanism is not working properly, it can contribute to the development of cardiovascular disease," explains Charlotte Ling, professor of diabetes research at Lund University.

The researchers identified more than 400 alterations in DNA methylation in the blood, and used 87 of them to develop a score scale capable of assessing individual risk for serious cardiovascular complications. "We were able to predict with 96 % probability who was not at risk of developing cardiovascular disease. The negative predictive value was therefore very high," says García Calzón. "As the follow-up of the participants was just over seven years, a relatively short period, we need to extend it to also improve the positive predictive value, i.e., the probability that a person will actually suffer a cardiovascular event."

Improving detection to anticipate more precise treatments

Currently, healthcare uses clinical variables such as age, sex, blood pressure, smoking, harmful cholesterol, long-term blood sugar and kidney function to estimate future cardiovascular disease risk, which the experts say is an inaccurate tool . "But if you add DNA methylation, you get a much more rigorous measure of future risk. So, based on this research, we want to develop a kit for clinical use that, using a simple blood sample , can measure DNA methylation and predict who is at risk of disease using the scorescale," concludes Charlotte Ling.

In this way, people with subject 2 diabetes who are at risk of developing cardiovascular disease can receive early preventive financial aid in areas such as diet, physical activity and weight control. They could also benefit from improved blood sugar control and receive pharmacological treatment to protect their heart and blood vessels.