Multimarker panel based on PIGF for diabetes types 1 and 2
The present invention relates to a method and means for diagnosing or risk stratification of co-morbidities, particularly cardiovascular complications in diabetes patients. The invention particularly relates to a method for diagnosing whether a diabetes patient is suffering from a cardiovascular complication or is at risk of suffering from a cardiovascular complication, said method comprising the steps of (a) measuring, preferably in vitro, the level(s) of at least one cardiac hormone or a variant thereof in a sample from the patient, and (b) diagnosing the cardiovascular complication or the risk of suffering from cardiovascular complication by comparing the measured level(s) to known level(s) associated with the cardiovascular complication or risk. The present invention also relates to combining the measurement of markers comprising cardiac hormones, natriuretic peptides, inflammation-associated markers, angiogenesis-markers, and markers for platelet activation. Preferred markers are brain natriuretic peptides (particularly NT-proBNP), PlGF, and sCD 40 L.
1. A method for diagnosing a cardiovascular complication or a risk of a cardiovascular complication in a diabetes patient who is clinically asymptomatic for cardiac disease, the method comprising the steps of:
measuring in vitro the level of placental growth factor-1 (PlGF-1) in a sample from the patient,
measuring in vitro the level of at least one additional marker for a cardiovascular complication or a risk of a cardiovascular complication, wherein the additional marker is selected from the group consisting of N-terminal pro brain natriuretic peptide (NT-proBNP), C-reactive protein (CRP), high-sensitivity C-reactive protein (hsCRP), and interleukin 6 (IL-6), and
diagnosing the cardiovascular complication or the risk of a cardiovascular complication by comparing the measured levels to known levels associated with the cardiovascular complication or the risk, wherein a measured level of PlGF-1 higher than the known level associated with cardiovascular complication or risk, and a measured level of at least one or more of NT-proBNP, CRP, hsCRP, and IL-6 higher than the known level associated with cardiovascular complication, is indicative of a diagnosis of the cardiac complication or risk.
2. The method of claim 1 wherein the patient is suffering from Type 2 diabetes.
3. The method of claim 1 wherein the patient is suffering from diabetic nephropathy.
4. The method of claim 1 further comprising the step of diagnosing a manifestation of diabetes selected from the group consisting of inflammation and insufficient control of blood sugar level,
wherein a diagnosis of inflammation is made by measuring in vitro a level of CRP, hsCRP or IL-6 in a sample from a patient and comparing the measured level to a known level of CRP, hsCRP or IL-6 associated with inflammation, wherein a measured level higher than the known level is indicative of a diagnosis of inflammation; and
wherein a diagnosis of insufficient control of blood sugar level is made by measuring in vitro a level of glucose, hemoglobin A1c (HbA1c), N ε -(carboxymethyl)lysine (CML) or advanced glycation endproducts (AGEs) in a sample from a patient and comparing the measured level to a known level of glucose, HbA1c, CML or AGEs associated with insufficient control of blood sugar level, wherein a measured level higher than the known level is indicative of a diagnosis of insufficient control of blood sugar level.