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NT-proCNP levels predict higher atherosclerotic cardiovascular risk profile in patients with proliferative diabetic retinopathy

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Abstract

Aims

In this study, we aimed to demonstrate the effectiveness of serum amino-terminal proCNP (NT-proCNP) levels in predicting coronary heart disease (CHD) and cardiovascular risk in type 2 diabetes mellitus (T2DM) patients.

Methods

We recruited 73 patients with T2DM in the study. Additionally, we grouped the patients according to their status of diabetic retinopathy (DR) as no DR, non-proliferative DR, or proliferative DR. Serum NT-proCNP levels of the patients were measured and their atherosclerotic cardiovascular disease (ASCVD) risk scores were calculated.

Results

There was no significant difference in terms of NT-proCNP levels between the groups (p = 0.3) and in terms of CHD and ASCVD risk scores (p = 0.4 and p = 0.4, respectively). In the correlation analysis, a significant correlation was observed between the NT-proCNP levels and the ASCVD risk score (r = 0.373; p = 0.008 among the entire cohort and r = 0.555; p = 0.01 in the non-proliferative-DR group), smoking status (r = 0.280; p = 0.03 among the entire cohort and r = 0.362; p = 0.035 in the non-proliferative-DR group), sBP (r = 0.278; p = 0.038 among the entire cohort), and dBP (r = 0.284; p = 0.034 among the entire cohort and r = 0.482; p = 0.004 in the proliferative-DR group). In the ROC analysis, we found that the NT-proCNP level predicted a high ASCVD risk score with 83.3% sensitivity and 70.8% specificity and a very high ASCVD risk score with 100% sensitivity and 69.2% specificity among the proliferative-DR patients. No cut-off value was calculated for the prediction of high and very-high ASCVD risk scores in patients with non-proliferative DR. Similarly, no cut-off value was revealed for the prediction of established coronary artery disease in all groups.

Conclusions

Our study revealed a significant association between NT-proCNP levels and high ASCVD risk scores in patients with proliferative DR.

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Funding

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Authors and Affiliations

  1. Division of Nephrology, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Fatih, 34360, Istanbul, Turkey

    Cebrail Karaca, Mevlut T. Dincer, Nurhan Seyahi & Sinan Trabulus

  2. Division of Rheumatology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey

    Murat Bektas

  3. Division of Gastroenterohepatology, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey

    Oguz K. Bakkaloglu

  4. Department of Ophthalmology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey

    Zafer Cebeci

  5. Department of Social Pediatrics, Institute of Child Health, Istanbul University, Istanbul, Turkey

    Alev Bakir

  6. Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey

    Tufan Tukek

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  1. Cebrail Karaca
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Correspondence to Sinan Trabulus.

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The authors declare no conflicts of interest. All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.

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The local medical ethics committee approved the study protocol (approval number: 497).

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All participants gave written informed consent before their inclusion in the study. The study was conducted in accordance with the 1975 Declaration of Helsinki, as revised in 2013.

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This article belongs to the Topical Collection “Diabetic Eye Disease”, managed By Giuseppe Querques.

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Karaca, C., Bektas, M., Dincer, M.T. et al. NT-proCNP levels predict higher atherosclerotic cardiovascular risk profile in patients with proliferative diabetic retinopathy. Acta Diabetol 60, 1027–1036 (2023). https://doi.org/10.1007/s00592-023-02095-y

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  • DOI: https://doi.org/10.1007/s00592-023-02095-y

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