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0:00
Hello, my
name is Naveed Sattar.
I am professor of metabolic medicine
at the University of Glasglow,
and I am going to give you an
overview of diabetes biomarkers.
0:12
So biomarkers, what are they?
And what are they for?
Biomarkers are really any measure,
whether it's biological material
or even a clinical
characteristic which
gives you insight
into either disease,
pathogenesis, prediction of
complications or progression
of follow up. Or it can
actually give you an insight
into the response of an
individual to a particular therapy
or intervention.
So biomarkers can range from simple
things such as age, social class,
but of course, most people
understand the term biomarkers
in terms of some blood measure
or some biochemical parameter,
for example, cholesterol or glucose.
0:52
If we take cardiovascular disease
as an example of how they have used
biomarkers, well, we
are now at a point
where we know that age, blood
pressure, smoking, gender, lipids,
and the presence of diabetes gives
insight into cardiovascular risk.
And from this, we have developed
cardiovascular risk scores,
ranging from the original
Framingham risk scores
through to the risk score in Europe,
as well as more sophisticated risk
scores which have added other
potential parameters which we
will discuss in the
next couple of slides.
There is big-scale epidemiology
on these routine biomarkers
in cardiovascular disease
in terms of prediction.
And some of the lessons we have
learned from cardiovascular disease
in terms of predicting disease
are relevant to diabetes research.
1:34
If we take first the relationship of
lipids to cardiovascular outcomes,
this has now been established
in huge data sets, culminating
in collaboration of multiple
cohorts called Emerging Risk Factor
Collaboration, which reported
the lipid data in 2009 in JAMA,
and shows clearly that
non-HDL or LDL is strongly
and linearly related to hazard
ratio cardiovascular events.
HDL is inversely related, and
triglyceride is positively related
in analysis adjusted for age and sex
only, whilst LDL or non-HDL and HDL
remain associated with CHD in the
same pattern one to further
adjusted for non-lipid
and lipid factors.
Triglyceride actually
shows no association
once other lipid parameters
and another risk factors
are accounted for.
This suggests that actually, LDL and
HDL or total cholesterol and HDL
are all that we really
need in terms of predicting
cardiovascular disease, and
that triglyceride does not
add prediction over and
above other lipid markers.
And in actual fact, further evidence
published in other papers which
suggests that triglyceride
is in fact a stronger risk
factor in the development
of diabetes than it
is for cardiovascular disease.
