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Blood tests can be a useful tool for measuring proteins linked to heart disease. Willie B. Thomas/Getty Images
  • Researchers say one-third of people with type 2 diabetes may have undetected cardiovascular disease.
  • In a new study, the researchers reported that many people with type 2 diabetes had elevated levels of two proteins associated with heart disease.
  • They said the study results emphasize the need for medical professionals to check for cardiovascular disease in people with type 2 diabetes.

One-third of people with type 2 diabetes had elevated levels of two protein markers, compared to 16% of those without diabetes, according to a study published today in the Journal of the American Heart Association.

Researchers analyzed health information and blood samples from 10,300 adults who participated in the National Health and Nutrition Examination Survey.

That survey collected the data from 1999-2004.

The study participants had not reported any history of cardiovascular disease when they enrolled.

The researchers honed in on two protein markers – troponin T and N terminal pro-B-type natriuretic peptide – that are used to measure injury and stress to the heart and are routinely used to diagnose a heart attack and heart failure.

Elevated levels of these proteins in the bloodstream might be early warning signs of changes in the structure and function of the heart, which could increase the risk of heart failure, coronary heart disease, and early death.

After analyzing the blood samples as well as mortality statistics collected from the National Death Index, the scientists reported that:

  • One-third of people with type 2 diabetes had elevated levels of the two protein markers, compared to 16% of those without diabetes.
  • In people with type 2 diabetes, elevated levels of the protein markers were associated with an increased risk of all-cause death and more than double the risk of cardiovascular death compared to people with normal levels of these proteins in the blood. The elevated risk remained after adjusting for other cardiovascular risk factors.
  • Elevated troponin was more common in people with type 2 diabetes, even after adjustment for age and demographic characteristics.
  • The prevalence of elevated troponin was significantly higher in people who had type 2 diabetes for a more extended period and did not have well-controlled blood sugar levels.

The researchers concluded that about one-third of adults in the United States with type 2 diabetes might have undetected cardiovascular disease.

Routine screenings for these biomarkers could help reduce the risk of cardiovascular events in this higher-risk population.

“Another piece of the puzzle demonstrating that certain biomarkers help identify individuals at increased long-term risk,” said Dr. Jeffrey Berger, a preventive cardiologist and the director of the Center for the Prevention of Cardiovascular Disease at NYU Langone Heart in New York.

“While important, a missing piece is understanding what to do with these individuals with elevation of these biomarkers – certainly they should be given lifestyle recommendations of the importance of healthy lifestyle (exercise and nutrition) which would hopefully attenuate some of this risk,” Berger told Medical News Today.

People with diabetes are more likely than the general public to have heart diseaase, according to the Centers for Disease Control and Prevention.

Heart failure occurs when your heart can’t pump blood well. Fluid accumulates in your lungs, making breathing difficult and causing your legs swell.

People with diabetes also have a higher risk of developing:

High blood sugar can also damage the nerves and blood vessels that control the heart.

“This study highlights the significant burden of subclinical cardiovascular disease that is present in those with type II diabetes mellitus,” Dr. Rigved Tadwalkar, a cardiologist at Providence Saint John’s Health Center in California, told Medical News Today. “The authors make a compelling argument for using biomarkers routinely in this higher-risk patient population to stratify risk better.”

During each office visit, doctors record weight and blood pressure. These measurements, in addition to any blood tests done, help doctors better understand a person’s risk of developing heart disease.

Other medical tests used to check heart health include:

The current study indicates that adding tests for biomarkers to the diagnostic process might be advantageous.

“While the study provides valuable insights into the importance of biomarkers in those with type II diabetes mellitus, it should be interpreted cautiously, considering existing guidelines and an individual’s health status,” said Tadwalkar. “It is noteworthy that the American Diabetes Association already recommends performing testing of hs-cTn and NT-proBNP in adults with diabetes.”

“Nonetheless, longer-term randomized trials are needed to establish the true clinical benefits, cost-effectiveness, and risk stratification abilities of routine biomarker testing in this population,” he added. “This data would help better determine how to integrate routine biomarker assessment into practice best.”

Berger said the current work on biomarkers will lead to better and more precise care.

“We have many prognostic biomarkers and tests that discriminate increased risk – the community needs studies investigating what to do if someone is at increased risk – the future is precision-based care,” he said.