Biomarkers of Oxidative Stress Do Not Predict MACE in Type 2 Diabetes

Blood test, blood in vial
Blood test, blood in vial
Investigators examined 6 biomarkers for predicting adverse cardiovascular outcomes in patients with type 2 diabetes.

A study published in the Journal of the American Heart Association has shown that the plasma concentrations of 6 biomarkers of oxidative stress do not help predict major adverse cardiovascular events (MACE) in individuals with type 2 diabetes mellitus.

The study included 1468 individuals from SURDIAGENE (Survie, Diabete de type 2 et Genetique), a prospective cohort study of individuals who had type 2 diabetes for a minimum of 2 years and who were ≥ 18 years. Participants were given baseline assessments and then monitored for 64 months for MACE, including stroke, first incidence of cardiovascular death, and myocardial infarction. Venous blood samples were taken to examine the degree of biomarkers of oxidative stress, which included fluorescent advanced glycation end products, advanced oxidation protein products, oxidative hemolysis inhibition assay, enzyme-linked immunosorbent assay carbonyl, ischemia-modified albumin, and total reductive capacity of plasma.

The only biomarkers univariately linked with MACE were carbonyls (hazard ratio [HR] 1.15 per SD, 95% confidence interval [CI] 1.04-1.27, =.006) and fluorescent advanced glycation end products (HR 1.38 per SD, 95% CI, 1.24-1.54, <.001). However, these biomarkers did not produce significant improvement of the model’s integrated discrimination index or c-statistics when analyzed in a multivariate model that took standard MACE risk factors into account. These risk factors included but were not limited to body mass index, hypertension history, smoking status, age, and sex, and their inclusion in the model allowed study researchers to isolate the prognostic power of individual biomarkers.

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Researchers conclude that these “plasma concentrations of 6 markers, which cover a broad spectrum of oxidative processes, were not significantly associated with MACE occurrence and were not able to improve MACE risk discrimination and classification beyond classical risk factors in type 2 diabetes mellitus patients.”


Cournot M, Burillo E, Saulnier P-J, et al. Circulating concentrations of redox biomarkers do not improve the prediction of adverse cardiovascular events in patients with type 2 diabetes mellitus. J Am Heart Assoc. 2018;7:e007397. doi: 10.1161