Immunological and Cardiometabolic Risk Factors in the Prediction of Type 2 Diabetes and Coronary Events: MONICA-KORA Augsburg Case-Cohort StudyReportar como inadecuado

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This study compares inflammation-related biomarkers with established cardiometabolic risk factors in the prediction of incident type 2 diabetes and incident coronary events in a prospective case-cohort study within the population-based MONICA-KORA Augsburg cohort.

Methods and Findings

Analyses for type 2 diabetes are based on 436 individuals with and 1410 individuals without incident diabetes. Analyses for coronary events are based on 314 individuals with and 1659 individuals without incident coronary events. Mean follow-up times were almost 11 years. Areas under the receiver-operating characteristic curve AUC, changes in Akaike-s information criterion ΔAIC, integrated discrimination improvement IDI and net reclassification index NRI were calculated for different models. A basic model consisting of age, sex and survey predicted type 2 diabetes with an AUC of 0.690. Addition of 13 inflammation-related biomarkers CRP, IL-6, IL-18, MIF, MCP-1-CCL2, IL-8-CXCL8, IP-10-CXCL10, adiponectin, leptin, RANTES-CCL5, TGF-β1, sE-selectin, sICAM-1; all measured in nonfasting serum increased the AUC to 0.801, whereas addition of cardiometabolic risk factors BMI, systolic blood pressure, ratio total-HDL-cholesterol, smoking, alcohol, physical activity, parental diabetes increased the AUC to 0.803 ΔAUC 95% CI 0.111 0.092–0.149 and 0.113 0.093–0.149, respectively, compared to the basic model. The combination of all inflammation-related biomarkers and cardiometabolic risk factors yielded a further increase in AUC to 0.847 ΔAUC 95% CI 0.044 0.028–0.066 compared to the cardiometabolic risk model. Corresponding AUCs for incident coronary events were 0.807, 0.825 ΔAUC 95% CI 0.018 0.013–0.038 compared to the basic model, 0.845 ΔAUC 95% CI 0.038 0.028–0.059 compared to the basic model and 0.851 ΔAUC 95% CI 0.006 0.003–0.021 compared to the cardiometabolic risk model, respectively.


Inclusion of multiple inflammation-related biomarkers into a basic model and into a model including cardiometabolic risk factors significantly improved the prediction of type 2 diabetes and coronary events, although the improvement was less pronounced for the latter endpoint.

Autor: Christian Herder, Jens Baumert, Astrid Zierer, Michael Roden, Christa Meisinger, Mahir Karakas, Lloyd Chambless, Wolfgang Rathman



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