Biomarkers of endothelial function and early renal impairment: Associations with type 2 diabetes mellitus (Results from the Western New York Study)
Rejman, Karol Pohlman
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Type 2 diabetes mellitus is a significant public health problem in the United States. According to the National Center for Chronic Disease Prevention and Health Promotion, over 19 million Americans (7% of the population) have diabetes and 16 million people have prediabetic conditions. Few studies have been done to identify biomarkers that predict incident type 2 diabetes. Hypotheses. Increased levels of E-selectin and cystatin-C will predict incident type 2 diabetes mellitus. Methods. The WNY Follow-up Study is a six year follow-up study of a population-based sample from the Western New York Health Study (WNYHS). WNYHS participants were a random sample initially recruited from Erie and Niagara counties (mean age 54 years, 95% white) without evident CVD and examined from 1996-2000. At the first follow-up examination in 2003-2004, incident cases of DM were defined by self-report plus the use of oral hypoglycemic agents or insulin, or fasting plasma glucose greater than 125 mg/dl. The cases were matched to controls (3:1) on the basis of gender, ethnicity, baseline glycemic status (<110 mg/dl, 110-125 mg/dl), and year of entry into the study. Conditional logistic regression was used to estimate the odds ratio (OR)and 95% confidence intervals (95%CI) of type 2 diabetes mellitus. The OR (95% CI) of E-selectin for diabetes conditioned on only the matching variables was 2.63 (95% CI: 1.06, 6.54; p=0.04) (comparing the top tertile of E-selectin to the bottom). Control for additional covariates included age, BMI, cigarette use, physical activity, family history of diabetes, and alcohol use. The unadjusted OR of cystatin C for type 2 diabetes was 1.20 (95%CI: 0.61-2.67; p=0.60) for the top quintile versus the remainder. Conclusions. E-selectin is an independent predictor of incident type 2 diabetes in this community-dwelling, middle aged population. Cystatin-c does not predict incident type 2 diabetes in this population.