title: Role of Serum Biomarkers in Early Detection of Diabetic Cardiomyopathy in the West Virginian Population.
abstract: OBJECTIVE
  Diabetic cardiomyopathy (DCM) is an established complication of diabetes mellitus. In West Virginia, the especially high incidence of diabetes and heart failure validate the necessity of developing new strategies for earlier detection of DCM. Since most DCM patients remain asymptomatic until the later stages of the disease when the fibrotic complications become irreversible, we aimed to explore biomarkers that can identify early-stage DCM.
  
  
  METHODS
  The patients were grouped into 4 categories based on clinical diabetic and cardiac parameters: Control, Diabetes (DM), Diastolic dysfunction (DD), and Diabetes with diastolic dysfunction (DM+DD), the last group being the preclinical DCM group.
  
  
  RESULTS
  Echocardiography images indicated severe diastolic dysfunction in patients with DD+DM and DD compared to DM or control patients. In the DM and DM+DD groups, TNFα, isoprostane, and leptin were elevated compared to control (p<0.05), as were clinical markers HDL, glucose and hemoglobin A1C. Fibrotic markers IGFBP7 and TGF-β followed the same trend. The Control group showed higher beneficial levels of adiponectin and bilirubin, which were reduced in the DM and DM+DD groups (p<0.05).
  
  
  CONCLUSIONS
  The results from our study support the clinical application of biomarkers in diagnosing early stage DCM, which will enable attenuation of disease progression prior to the onset of irreversible complications.
authors.affiliation: 1. Department of Medicine Joan C. Edwards School of Medicine, Marshall University;
authors.forename: Adam
authors.initials: A
authors.lastname: Shaver
authors.affiliation: 1. Department of Medicine Joan C. Edwards School of Medicine, Marshall University;
authors.forename: Alexandra
authors.initials: A
authors.lastname: Nichols
authors.affiliation: 2. Department of Cardiology, Marshall University;
authors.forename: Ellen
authors.initials: E
authors.lastname: Thompson
authors.affiliation: 1. Department of Medicine Joan C. Edwards School of Medicine, Marshall University;
authors.forename: Amrita
authors.initials: A
authors.lastname: Mallick
authors.affiliation: 1. Department of Medicine Joan C. Edwards School of Medicine, Marshall University;
authors.forename: Kristen
authors.initials: K
authors.lastname: Payne
authors.affiliation: 2. Department of Cardiology, Marshall University;
authors.forename: Chris
authors.initials: C
authors.lastname: Jones
authors.affiliation: 3. Department of Public Health, Marshall University;
authors.forename: Nandini D P K
authors.initials: ND
authors.lastname: Manne
authors.affiliation: 1. Department of Medicine Joan C. Edwards School of Medicine, Marshall University;
authors.forename: Shanmuga
authors.initials: S
authors.lastname: Sundaram
authors.affiliation: 1. Department of Medicine Joan C. Edwards School of Medicine, Marshall University;
authors.forename: Joseph I
authors.initials: JI
authors.lastname: Shapiro
authors.affiliation: 4. Department of Surgery and Pharmacology, Marshall University, USA.
authors.forename: Komal
authors.initials: K
authors.lastname: Sodhi
mesh_terms: D052242:Adiponectin / Q000097:blood; D001663:Bilirubin / Q000097:blood; D015415:Biomarkers / Q000097:blood*; D016022:Case-Control Studies; D058065:Diabetic Cardiomyopathies / Q000097:blood* / Q000175:diagnosis*; D004562:Electrocardiography; D006801:Humans; D018969:Insulin-Like Growth Factor Binding Proteins / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D028421:Isoprostanes / Q000097:blood; D020738:Leptin / Q000097:blood; D016212:Transforming Growth Factor beta / Q000097:blood; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D014903:West Virginia
chemical_list: C499918:ADIPOQ protein, human; D052242:Adiponectin; D015415:Biomarkers; C508600:IL6 protein, human; D018969:Insulin-Like Growth Factor Binding Proteins; D015850:Interleukin-6; D028421:Isoprostanes; D020738:Leptin; D016212:Transforming Growth Factor beta; D014409:Tumor Necrosis Factor-alpha; C102529:insulin-like growth factor binding protein-related protein 1; D001663:Bilirubin
keywords: West Virginia; cardiomyopathy; diabetes; serum biomarkers.