Cardiale troponine T elevaties gebruikelijk bij type 2 diabetes

Nieuws - Sep. 22, 2010

Cardiac troponin T elevations common in Type 2 diabetes

22 September 2010

Elevated circulating levels of cardiac troponin (cTn)T, measured using a sensitive assay, are common in patients with Type 2 diabetes, researchers report.

They found that almost one in five participants with diabetes had cTnT levels above the 99th percentile of a reference population of healthy individuals. cTnT levels remained stable over time, were associated with conventional cardiovascular risk factors, and also displayed a graded relationship with hospitalizations during 2 years of follow-up, although the latter result just missed statistical significance.

The researchers say the findings "alert the clinical community that individuals with Type 2 diabetes - even if fairly young and without much apparent comorbidity - have a substantial probability of having a chronically elevated cTnT value with the new high-sensitivity assay."

cTnT and cTnI are extremely sensitive and specific markers of myocardial necrosis and are crucial components in the diagnosis of myocardial infarction, say Jonas Hallén (Oslo University Hospital, Norway) and colleagues.

They measured cTnT in stored, frozen serum samples from 124 individuals with Type 2 diabetes enrolled in the Asker and Bærum Cardiovascular Diabetes trial at baseline, and at 2-year follow-up in the 96 for whom samples were available.

Overall, 90% of participants had detectable cTnT at baseline, measured using the electrochemiluminescence method, and of these 18% had values above 13.5 ng/l, which was the 99th percentile in 616 apparently healthy volunteers in a control population.

Baseline cTnT levels were associated with the conventional cardiovascular risk factors of age, renal function, and gender, and there was a strong correlation between cTnT levels at the two time points studied.

The risk for hospital stays of at least 24 hours during follow-up increased step-wise with quartiles of baseline cTnT, although this finding was of borderline statistical significance.

Reporting in the journal Cardiovascular Diabetology, the researchers say their observations imply that troponin T release in this patient population reflects underlying and chronic pathophysiologic processes."Thus, troponin T may be a useful surrogate marker to define risk among subjects with Type 2 diabetes, and may facilitate early identification of patients with subclinical cardiovascular disease and other high-risk individuals," they say.

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