Global collaboration uncovering the missing link between diabetes, kidney disease and heart disease
CU Medicine leads an international team to reveal the link between diabetes, kidney disease and heart disease.
Researchers from CU Medicine have led a major international study that could help doctors predict and prevent serious health issues associated with type 2 diabetes by advancing our understanding of the links between diabetes, kidney disease and heart disease. The study’s insights could pave the way towards more effective risk screening and therapeutic treatments.
Diabetes is the most common cause of chronic kidney disease and contributes to half of new renal failure cases in Hong Kong every year. It is also associated with a two to four-fold increase in the risk of cardiovascular disease (CVD), with patients who suffer from diabetic kidney disease (DKD) facing even higher levels of CVD risk. CVD is a major cause of death among DKD patients, but the precise mechanisms that link diabetes, DKD and CVD have eluded scientists until now.
Searching for hidden signatures in the blood
To solve this puzzle, CU Medicine initiated a collaborative study to understand why individuals with type 2 diabetes are more likely to develop kidney and heart diseases, working alongside Amsterdam University Medical Center and Leiden University Medical Center in the Netherlands, Baker Heart and Diabetes Institute in Australia, and investigators in Hong Kong, Macao and the Chinese mainland.
The team analysed blood samples from almost 2,000 people with type 2 diabetes recruited from the Hong Kong Diabetes Biobank, scanning for specific substances that might serve as ‘biomarkers’ revealing the likelihood of complications well before they arise. This search identified 156 different biomarkers that correlate with kidney damage, as well as a distinct subset among these markers that could predict heart disease risk. A ‘signature’ set of predictive biomarkers was then validated with reference to large-scale diabetes databases in Hong Kong and the Netherlands. The study uncovered potential changes in the metabolism in people with diabetes that might explain the increased risk of heart disease in the presence of kidney dysfunction.
Spotting serious health risks with a simple test
This discovery has important implications. The identified biomarkers provide opportunities to develop blood tests to assess the risk of these life-threatening conditions for any patient with type 2 diabetes. It is a development that promises to enhance the precision of risk prediction as well as treatment plans and offers a beacon of hope for people with diabetes.
Prof. Juliana Chan, Chair Professor of Medicine and Therapeutics and Head of Division of Clinical Pharmacology, said, ‘With better understanding of the potential metabolic links between DKD and CVD, we will be able to make a more precise prediction of heart disease risk in DKD patients and to provide more informed therapeutic suggestions.’
Prof. Ronald Ma, S.H. Ho Professor of Diabetes and Head (Academic Affairs) in the Division of Endocrinology and Diabetes, added, ‘This study highlights the importance of establishing biobanks to advance understanding disease mechanisms and biomarker discovery, and the potential synergies between different cohorts and biobanks. Without these well-established biobanking initiatives in Hong Kong and the Netherlands, these collaborative studies and findings would not have been possible.’
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