Associations of Cardiac, Kidney, and Diabetes Biomarkers With Peripheral Neuropathy among Older Adults in the Atherosclerosis Risk in Communities (ARIC) Study

• Published in: Clinical chemistry (Baltimore, Md.) Md.), 2020-05, Vol.66 (5), p.686-696
• Main Authors: Hicks, Caitlin W, Wang, Dan, Daya, Natalie R, Windham, B Gwen, Ballantyne, Christie M, Matsushita, Kunihiro, Selvin, Elizabeth
• Format: Article
• Language: English
• Subjects: Adults; Aged; Aged, 80 and over; Albumin; Albumins; Arteriosclerosis; Atherosclerosis; Biomarkers; Biomarkers - blood; Brain natriuretic peptide; C-reactive protein; Calcium-binding protein; Creatinine; Cross-Sectional Studies; Cystatin C; Diabetes; Diabetes mellitus; Diabetic Neuropathies - blood; Diabetic Neuropathies - diagnosis; Female; Heart; Hemoglobin; Humans; Hyperglycemia; Inflammation; Kidney - metabolism; Kidneys; Male; Myocardium - metabolism; Older people; Peripheral neuropathy; Regression Analysis; Risk analysis; Risk Factors; Statistics, Nonparametric; Troponin; Troponin T - blood
• ISSN: 0009-9147; 1530-8561
• DOI: 10.1093/clinchem/hvaa051

Abstract Background The aim of this study was to assess the association of high-sensitivity cardiac troponin (hs-cTnT) and other cardiac, kidney, hyperglycemia, and inflammatory biomarkers with peripheral neuropathy (PN) in a community-based population. Methods We conducted a cross-sectional analysis of 3056 black and white participants in the Atherosclerosis Risk in Communities (ARIC) study who underwent standardized monofilament PN testing and had measures of cardiac function (hs-cTnT, N-terminal pro–B-type natriuretic peptide [NT-proBNP], and growth differentiation factor 15 [GDF15]), kidney function (serum creatinine, cystatin C, β-2 microglobulin, urine albumin-to-creatinine ratio), hyperglycemia (fasting glucose, hemoglobin A1c [Hb A1c], fructosamine, glycated albumin, 1,5-anhydroglucitol), and inflammation (C-reactive protein) assessed at visit 6 (2016–2017; age 71–94 years). We used logistic regression to assess the associations of these biomarkers (modeled in diabetes-specific tertiles) with PN in older adults with and without diabetes after adjusting for traditional risk factors. Results In total, 33.5% of participants had PN (37.3% with diabetes and 31.9% without diabetes). There was an independent association of hs-cTnT with PN regardless of diabetes status (diabetes T3 vs. T1: odds ratio [OR], 2.15 [95% CI, 1.44–3.22]; no diabetes: OR, 2.31 [95%CI, 1.76–3.03]; P = 0.72 for interaction). Among participants without diabetes, there were also significant associations of NT-proBNP (OR, 1.40 [95% CI, 1.08–1.81]) and urine albumin-to-creatinine ratio (OR, 1.55 [95% CI, 1.22–1.97]) with PN. Associations of hyperglycemia biomarkers including Hb A1c (OR, 1.76 [95% CI, 1.22–2.54]), fructosamine (OR, 1.71 [95% CI, 1.19–2.46]), and glycated albumin (OR, 1.45 [95% CI, 1.03–2.03]) with PN were significant only among participants with diabetes. Conclusions Overall, hs-cTnT appears to be a global marker of end organ damage, including PN. Laboratory biomarkers may be able to help us identify those individuals with PN.