Better way to gauge heart disease risk in diabetes

"The risk of people with type 1 diabetes developing heart disease is better predicted by looking at the ratio of factors representing protection—for example, antioxidants—to those representing harm—for example oxidative stress levels," says Tina Costacou. (Credit: fotobaba/GK/Flickr)

Looking at harmful risk factors alone may not be the best way to predict the likelihood a person with type 1 diabetes will develop heart disease.

“Currently in clinical practice, physicians assess a patient’s risk factors for developing a disease to determine what, if any, preventative measures to take,” says Tina Costacou, assistant professor of epidemiology at the University of Pittsburgh Graduate School of Public Health.

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“In our study, we found that the risk of people with type 1 diabetes developing heart disease is better predicted by looking at the ratio of factors representing protection—for example, antioxidants—to those representing harm—for example oxidative stress levels.

“Currently, doctors most commonly determine heart disease risk by looking at the level of harmful risk factors alone, which may not give an accurate picture of the person’s risk.”

As reported in the journal Diabetes Care, a statistical analysis over time indicates that patients with higher levels of oxidative stress (measured with a urine test) who also had higher levels of a form of the antioxidant vitamin E (measured with a blood test) had a lower risk of developing heart disease compared to those with higher levels of oxidative stress and lower levels of protective antioxidants.

More individualized treatment

Although both patient groups had higher levels of oxidative stress, they were actually at a different risk of developing heart disease, researchers say. Only those with the lower levels of antioxidants may need additional treatment to try to prevent heart disease from developing.

“This improved way of determining risk is not necessarily limited to the hypothesis of oxidative stress and antioxidants in terms of heart disease development. It could be expanded to other risk/protective factors and other pathologic conditions,” Costacou says.

“If further supportive data are published, it may one day become possible to better classify a person’s disease risk and individualize treatment based on simultaneous assessment of risk and protective factors.”

The National Institutes of Health funded the study.

Source: University of Pittsburgh