Introduction: Cardiovascular deaths are common in diabetic individuals. Serum cardiac troponin (cTn) T and I, and N-terminal pro-brain natriuretic peptide (NT-proBNP) are markers of cardiomyocyte stress or damage. In ambulatory type 2 diabetic patients, cTnT concentrations have been shown to predict cardiovascular events and death. In this study, the measurement of serum cardiac biomarkers (cTn and NT-proBNP) in ambulatory type 1 diabetic (T1D) patients for complications risk assessment has been investigated.
Methods: In a cross-sectional study of 107 ambulatory T1D patients, serum cTn T and I, and NT-proBNP were measured and were related to patient characteristics and diabetes complications using a generalised linear model.
Results: 14/107, 5/107 and 10/107 patients had elevated cTnT, cTnI and NT-proBNP, respectively. After adjustments for age, gender and diabetes duration, cTnT was significantly associated with the presence of elevated serum creatinine (P < 0.001), diabetic retinopathy (P = 0.005), and peripheral neuropathy (P = 0.001). However, with further adjustments for the presence of hypertension, dyslipidaemia, body mass index and HbA1c, only serum creatinine remained significantly associated with cTnT (P < 0.001). cTnI was only associated with the presence of any macrovascular complication (P = 0.041), even with adjustments. NT-proBNP was associated with the presence of elevated serum creatinine (P < 0.001) and macrovascular complication (P = 0.046).
Conclusion: cTnT was more significantly associated with diabetic microvascular complications, while cTnI with the presence of diabetic macrovascular complications. The presence of associations between cardiac biomarkers and diabetes complications in ambulatory T1D patients justifies future longitudinal studies to ascertain their prognostic value for adverse outcomes in this patient group.