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

• Published in: Acta diabetologica Vol. 60; no. 8; pp. 1027 - 1036
• Main Authors: Karaca, Cebrail, Bektas, Murat, Dincer, Mevlut T., Bakkaloglu, Oguz K., Cebeci, Zafer, Bakir, Alev, Seyahi, Nurhan, Trabulus, Sinan, Tukek, Tufan
• Format: Journal Article
• Language: English
• Published: Milan Springer Milan 01.08.2023; Springer Nature B.V
• Subjects: Arteriosclerosis; Atherosclerosis; Cardiovascular disease; Cardiovascular diseases; Coronary artery disease; Correlation analysis; Diabetes; Diabetes mellitus (non-insulin dependent); Diabetic retinopathy; Heart diseases; Internal Medicine; Medicine; Medicine & Public Health; Metabolic Diseases; Original Article; Retinopathy; Amino-terminal proCNP; Diabetic retinopathy; Type 2 diabetes mellitus; Atherosclerotic cardiovascular disease; C-type natriuretic peptide; Coronary heart disease
• ISSN: 1432-5233; 0940-5429; 1432-5233
• DOI: 10.1007/s00592-023-02095-y

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.