New findings from a Swedish study of people with recently diagnosed type 2 diabetes could help doctors identify those at low risk for developing cardiovascular diseases from those at higher risk.
Overall, people with type 2 diabetes are up to four times more likely to experience a heart attack, stroke, or another major cardiovascular event, compared to people without diabetes.
The 752 volunteers in the new study all had new diagnoses of type 2 diabetes, and none had a history of heart disease. During roughly seven years of follow-up, 102 of them suffered serious cardiovascular complications.
By analyzing blood samples obtained from participants at regular intervals, the researchers were able to track chemical changes in DNA over time.
Such changes, known as DNA methylation, "control which genes are active or turned off in our cells, and when it does not work properly, it can contribute to the development of cardiovascular disease", study leader Charlotte Ling of Lund University said in a statement.
The researchers found more than 400 sites with DNA methylation in blood. They were able to use 87 sites to develop a score scale for assessing patients' risk of developing serious cardiovascular complications.
The scale's negative predictive value – its accuracy at identifying patients at low risk of a major cardiovascular event - was 96%, researchers reported in Cell Reports Medicine.
But the scale was only about 32% accurate at identifying patients at high risk – probably because the study has not yet followed them for a long-enough period.
Still, the researchers wrote, their screening test "seems to be one of the most reliable prognostic tools" for discriminating patients with type 2 diabetes at low cardiac risk from those at possibly high risk, "allowing personalized treatment, optimized healthcare costs, and reduction of therapy-related side effects and patients' worries."
Healthcare providers currently look at clinical variables such as age, gender, blood pressure, smoking, harmful cholesterol, long-term blood sugar and kidney function to estimate the risk of future heart disease, "but it is a rather blunt tool," Ling said.
"If you add DNA methylation, you have a much better measure of a future risk."
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