Serum peroxiredoxin 4: a marker of oxidative stress associated with mortality in type 2 diabetes (ZODIAC-28)

• Published in: PloS one Vol. 9; no. 2; p. e89719
• Main Authors: Gerrits, Esther G, Alkhalaf, Alaa, Landman, Gijs W D, van Hateren, Kornelis J J, Groenier, Klaas H, Struck, Joachim, Schulte, Janin, Gans, Reinold O B, Bakker, Stephan J L, Kleefstra, Nanne, Bilo, Henk J G
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 25.02.2014; Public Library of Science (PLoS)
• Subjects: Aged; Angina pectoris; Angioplasty; Biomarkers; Biomarkers - blood; Blood pressure; Body mass; Cardiovascular diseases; Cardiovascular Diseases - mortality; Cholesterol; Complications; Coronary vessels; Creatinine; Development and progression; Diabetes; Diabetes mellitus; Diabetes Mellitus, Type 2; Drug dosages; Family medical history; Female; Gene expression; Glucose; Health aspects; Health hazards; Health risks; Hemoglobin; High density lipoprotein; Humans; Internal medicine; Male; Mammals; Mathematical models; Median (statistics); Medical research; Medicine; Middle Aged; Mortality; Netherlands - epidemiology; Oxidative Stress; Patients; Peroxiredoxin; Peroxiredoxins - blood; Predictions; Prognosis; Proportional Hazards Models; Proteins; Reclassification; Rheumatoid arthritis; Risk analysis; Risk Factors; Rodents; Sepsis; Smoking; Statistical analysis; Statistical methods; Type 2 diabetes; Zodiac; Netherlands
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0089719

Oxidative stress plays an underlying pathophysiologic role in the development of diabetes complications. The aim of this study was to investigate peroxiredoxin 4 (Prx4), a proposed novel biomarker of oxidative stress, and its association with and capability as a biomarker in predicting (cardiovascular) mortality in type 2 diabetes mellitus. Prx4 was assessed in baseline serum samples of 1161 type 2 diabetes patients. Cox proportional hazard models were used to evaluate the relationship between Prx4 and (cardiovascular) mortality. Risk prediction capabilities of Prx4 for (cardiovascular) mortality were assessed with Harrell's C statistic, the integrated discrimination improvement and net reclassification improvement. Mean age was 67 and the median diabetes duration was 4.0 years. After a median follow-up period of 5.8 years, 327 patients died; 137 cardiovascular deaths. Prx4 was associated with (cardiovascular) mortality. The Cox proportional hazard models added the variables: Prx4 (model 1); age and gender (model 2), and BMI, creatinine, smoking, diabetes duration, systolic blood pressure, cholesterol-HDL ratio, history of macrovascular complications, and albuminuria (model 3). Hazard ratios (HR) (95% CI) for cardiovascular mortality were 1.93 (1.57 - 2.38), 1.75 (1.39 - 2.20), and 1.63 (1.28 - 2.09) for models 1, 2 and 3, respectively. HR for all-cause mortality were 1.73 (1.50 - 1.99), 1.50 (1.29 - 1.75), and 1.44 (1.23 - 1.67) for models 1, 2 and 3, respectively. Addition of Prx4 to the traditional risk factors slightly improved risk prediction of (cardiovascular) mortality. Prx4 is independently associated with (cardiovascular) mortality in type 2 diabetes patients. After addition of Prx4 to the traditional risk factors, there was a slightly improvement in risk prediction of (cardiovascular) mortality in this patient group.