title: The relationship between N-terminal prosomatostatin, all-cause and cardiovascular mortality in patients with type 2 diabetes mellitus (ZODIAC-35).
abstract: BACKGROUND
  The hormone somatostatin inhibits growth hormone release from the pituitary gland and is theoretically linked to diabetes and diabetes related complications. This study aimed to investigate the relationship between levels of the stable somatostatin precursor, N-terminal prosomatostatin (NT-proSST), with mortality in type 2 diabetes (T2DM) patients.
  
  
  METHODS
  In 1,326 T2DM outpatients, participating in this ZODIAC prospective cohort study, Cox proportional hazards models were used to investigate the independent relationship between plasma NT-proSST concentrations with all-cause and cardiovascular mortality.
  
  
  RESULTS
  Median concentration of NT-proSST was 592 [IQR 450-783] pmol/L. During follow-up for 6 [3-10] years, 413 (31%) patients died, of which 176 deaths (43%) were attributable to cardiovascular causes. The age and sex adjusted hazard ratios (HRs) for all-cause and cardiovascular mortality were 1.48 (95%CI 1.14 - 1.93) and 2.21 (95%CI 1.49 - 3.28). However, after further adjustment for cardiovascular risk factors there was no independent association of log NT-proSST with mortality, which was almost entirely attributable to adjustment for serum creatinine. There were no significant differences in Harrell's C statistics to predict mortality for the models with and without NT-proSST: both 0.79 (95%CI 0.77 - 0.82) and 0.81 (95%CI 0.77 - 0.84).
  
  
  CONCLUSIONS
  NT-proSST is unsuitable as a biomarker for cardiovascular and all-cause mortality in stable outpatients with T2DM.
authors.affiliation: Isala, Diabetes Centre, P.O. box 10400, 8000 G.K, Zwolle, The Netherlands. p.r.van.dijk@isala.nl.
authors.forename: Peter R
authors.initials: PR
authors.lastname: van Dijk
authors.affiliation: Isala, Diabetes Centre, P.O. box 10400, 8000 G.K, Zwolle, The Netherlands. g.w.d.landman@isala.nl.
authors.forename: Gijs W D
authors.initials: GW
authors.lastname: Landman
authors.affiliation: Isala, Diabetes Centre, P.O. box 10400, 8000 G.K, Zwolle, The Netherlands. essenl@isala.nl.
authors.forename: Larissa
authors.initials: L
authors.lastname: van Essen
authors.affiliation: Sphingotec GmbH, Hennigsdorf, Germany. struck@sphingotec.de.
authors.forename: Joachim
authors.initials: J
authors.lastname: Struck
authors.affiliation: Isala, Diabetes Centre, P.O. box 10400, 8000 G.K, Zwolle, The Netherlands. k.h.groenier@umcg.nl.|Department of General Practice, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands. k.h.groenier@umcg.nl.
authors.forename: Klaas H
authors.initials: KH
authors.lastname: Groenier
authors.affiliation: Isala, Diabetes Centre, P.O. box 10400, 8000 G.K, Zwolle, The Netherlands. h.j.g.bilo@isala.nl.|Department of Internal Medicine, Isala, Zwolle, The Netherlands. h.j.g.bilo@isala.nl.|Department of Internal Medicine, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands. h.j.g.bilo@isala.nl.
authors.forename: Henk J G
authors.initials: HJ
authors.lastname: Bilo
authors.affiliation: Department of Internal Medicine, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands. s.j.l.bakker@umcg.nl.
authors.forename: Stephan J L
authors.initials: SJ
authors.lastname: Bakker
authors.affiliation: Isala, Diabetes Centre, P.O. box 10400, 8000 G.K, Zwolle, The Netherlands. n.kleefstra@isala.nl.|Department of Internal Medicine, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands. n.kleefstra@isala.nl.|Langerhans Medical Research group, Zwolle, The Netherlands. n.kleefstra@isala.nl.
authors.forename: Nanne
authors.initials: N
authors.lastname: Kleefstra
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000097:blood* / Q000150:complications / Q000401:mortality*; D002423:Cause of Death; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000097:blood*; D011498:Protein Precursors / Q000097:blood* / Q000737:chemistry; D017434:Protein Structure, Tertiary; D012307:Risk Factors; D013004:Somatostatin / Q000097:blood* / Q000737:chemistry
chemical_list: D010446:Peptide Fragments; D011498:Protein Precursors; D013004:Somatostatin; C028456:prosomatostatin