Association of cardio-renal biomarkers and mortality in the U.S.: a prospective cohort study
Authors' conclusion
In the diabetic population, elevated plasma levels of hs-cTnT, hs-cTnI, NT-proBNP, creatinine, cystatin C, and β-2 microglobulin serve as robust and straightforward predictors of long-term mortality compared to blood glucose levels and HbA1c values. Creatinine and cystatin C stand out as more precise markers for predicting diabetes mortality prior to blood glucose monitoring.
Study context
- Population
- Adults with diabetes in the U.S. National Health and Nutrition Examination Survey (NHANES)
- Participants
- 1,783 adults
- Exposure
- Cardio-renal blood biomarkers vs traditional risk factors and blood glucose monitoring for mortality prediction
- Outcome
- All-cause mortality
- Follow-up
- Median 7.42 years
Methodological detailsmultivariable Cox proportional hazards regression, NHANES
- Multivariable Cox proportional hazards regression
- NHANES
Main finding
As reported in the abstract
Improvement in predictive ability for all-cause mortality vs traditional risk factors
- Addition of hs-cTnT
- 56.4%
- Addition of hs-cTnI
- 29.5%
- Addition of NT-proBNP
- 38.1%
- Addition of creatinine
- 18.8%
- Addition of cystatin C
- 35.7%
- Addition of β-2 microglobulin
- 41.3%
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Diabetes mortality by creatinine quartile · median follow-up 7.42 yearsHighest quartilesvs 1st quartilesCreatinine; higher risk in highest quartile | 5.16 (1.87–14.22) | |
| Diabetes mortality by cystatin C quartile · median follow-up 7.42 yearsHighest quartilesvs 1st quartilesCystatin C; higher risk in highest quartile | 10.06 (4.20–24.13) | |
| 0.050.21520Hazard ratio (log scale) |
Original publication
Association of cardio-renal biomarkers and mortality in the U.S.: a prospective cohort study. Cardiovasc Diabetol. Published 29 September 2023. doi:10.
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