Action in Diabetes and Vascular disease Preterax and Diamicron-MR Controlled Evaluation Biomarker Studies (ADVANCE-Biomarker)

Type 2 diabetes has grown into a major health problem, both in Australia and around the world. Heart attacks, strokes and kidney failure are common and serious consequences of having type 2 diabetes. Working with blood samples from patients of the ADVANCE trial, the ADVANCE-Biomarker study will compare the number of deaths and major cardiovascular events in type 2 diabetes patients using established biomarkers, which are biological reactions to medications which help scientists understand and track disease in the body. The results of this study will help physicians prescribe the best combination of medications for patients with type 2 diabetes and help these patients get back to living their lives without the added burden of a heart attack or kidney failure.

Type 2 diabetes mellitus (DM) is a major and growing health problem. Cardiovascular (CV) complications and kidney failure are the most common and serious consequences of DM. the current program of research considers the ability of novel and more established biomarkers to predict such complications and assess what value they provide, over and above existing methods of risk assessment.

Aims

The main aims of the current studies are to:

  • Determine whether levels of the advanced glycation end-product (AGE), Ne-(carboxymethyl)lysine (CML), and the soluble receptor for advanced glycation end-product (sRAGE) independently predict death, major CV events (death, heart attack and stroke) and kidney disease in patients with type 2 DM
  • Assess the ability of more established biomarkers of cardiovascular risk - high sensitivity C-reactive protein (hsCRP), fibrinogen, N-terminal pro-B-type natriuretic peptide (NT proBNP) and high sensitivity troponin T (hs TnT) - to predict, death, CV events and kidney disease in this population
  • Assess the ability of these markers, individually or in combination, to improve existing risk prediction models in patients with type 2 DM

Methods

The studies will use blood samples collected as part of the Action in diabetes and vascular disease: preterax and diamicrom-MR Controlled Evaluation (ADVANCE) study. We will perform several studies that will assess the ability of the aforementioned biomarkers to predict death, CV events and kidney disease.