title: Elevated serum free light chains predict cardiovascular events in type 2 diabetes.
abstract: OBJECTIVE
  Elevated polyclonal serum immunoglobulin free light chains (FLCs; combined FLCκ+FLCλ [cFLC]) are associated with adverse clinical outcomes and increased mortality; we investigated cFLC and cardiovascular disease (CVD) events in type 2 diabetes.
  
  
  METHODS
  In a cohort study of 352 south Asian patients with type 2 diabetes, serum cFLC, high-sensitivity C-reactive protein (hsCRP), and standard biochemistry were measured. CVD events over 2 years were recorded and assessed using multiple logistic regression.
  
  
  RESULTS
  cFLC levels were elevated significantly in 29 of 352 (8%) patients with CVD events during 2 years of follow-up (50.7 vs. 42.8 mg/L; P = 0.004). In multivariate analysis, elevated cFLC (>57.2 mg/L) was associated with CVD outcomes (odds ratio 3.3 [95% CI 1.3-8.2]; P = 0.012) and remained significant after adjusting for age, albumin-to-creatinine ratio, diabetes duration, or treatment.
  
  
  CONCLUSIONS
  cFLC elevation is a novel marker for CVD outcomes in type 2 diabetes that warrants further investigation.
authors.affiliation: Aston Research Centre for Healthy Ageing, Aston University, Birmingham, U.K.Diabetes Centre, Heart of England NHS Foundation Trust, Birmingham, U.K. s.bellary@aston.ac.uk.
authors.forename: Srikanth
authors.initials: S
authors.lastname: Bellary
authors.affiliation: The Binding Site Group Ltd, Birmingham, U.K.
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Faint
authors.affiliation: The Binding Site Group Ltd, Birmingham, U.K.
authors.forename: Lakhvir K
authors.initials: LK
authors.lastname: Assi
authors.affiliation: Hawke's Bay District Health Board, Hawkes Bay, New Zealand.
authors.forename: Colin A
authors.initials: CA
authors.lastname: Hutchison
authors.affiliation: The Binding Site Group Ltd, Birmingham, U.K.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Harding
authors.affiliation: Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, U.K.
authors.forename: Neil T
authors.initials: NT
authors.lastname: Raymond
authors.affiliation: Diabetes Centre, Heart of England NHS Foundation Trust, Birmingham, U.K.University of Birmingham, Birmingham, U.K.
authors.forename: Anthony H
authors.initials: AH
authors.lastname: Barnett
mesh_terms: D044466:Asian People; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology*; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007147:Immunoglobulin Light Chains / Q000097:blood*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged
chemical_list: D015415:Biomarkers; D007147:Immunoglobulin Light Chains; D002097:C-Reactive Protein