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World J Diabetes. Jun 15, 2021; 12(6): 685-705
Published online Jun 15, 2021. doi: 10.4239/wjd.v12.i6.685
Role of novel biomarkers in diabetic cardiomyopathy
Marko Kumric, Tina Ticinovic Kurir, Josip A Borovac, Josko Bozic
Marko Kumric, Tina Ticinovic Kurir, Josip A Borovac, Josko Bozic, Department of Pathophysiology, University of Split School of Medicine, Split 21000, Croatia
Tina Ticinovic Kurir, Department of Endocrinology, University Hospital of Split, Split 21000, Croatia
Josip A Borovac, Emergency Medicine, Institute of Emergency Medicine of Split-Dalmatia County, Split 21000, Croatia
Author contributions: Kumric M, Ticinovic Kurir T and Bozic J for conceptualization, original draft preparation, and supervision; Kumric M and Borovac JA for review of literature and visualization; All authors contributed to the final draft of the manuscript; all authors have read and agreed to the published version of the manuscript.
Conflict-of-interest statement: We report no conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Josko Bozic, MD, PhD, Associate Professor, Department of Pathophysiology, University of Split School of Medicine, Soltanska 2, Split 21000, Croatia. josko.bozic@mefst.hr
Received: December 28, 2020
Peer-review started: December 28, 2020
First decision: January 11, 2021
Revised: January 22, 2021
Accepted: March 18, 2021
Article in press: March 18, 2021
Published online: June 15, 2021
Processing time: 157 Days and 16.6 Hours
Abstract

Diabetic cardiomyopathy (DCM) is commonly defined as cardiomyopathy in patients with diabetes mellitus in the absence of coronary artery disease and hypertension. As DCM is now recognized as a cause of substantial morbidity and mortality among patients with diabetes mellitus and clinical diagnosis is still inappropriate, various expert groups struggled to identify a suitable biomarker that will help in the recognition and management of DCM, with little success so far. Hence, we thought it important to address the role of biomarkers that have shown potential in either human or animal studies and which could eventually result in mitigating the poor outcomes of DCM. Among the array of biomarkers we thoroughly analyzed, long noncoding ribonucleic acids, soluble form of suppression of tumorigenicity 2 and galectin-3 seem to be most beneficial for DCM detection, as their plasma/serum levels accurately correlate with the early stages of DCM. The combination of relatively inexpensive and accurate speckle tracking echocardiography with some of the highlighted biomarkers may be a promising screening method for newly diagnosed diabetes mellitus type 2 patients. The purpose of the screening test would be to direct affected patients to more specific confirmation tests. This perspective is in concordance with current guidelines that accentuate the importance of an interdisciplinary team-based approach.

Keywords: Diabetic cardiomyopathy; Heart failure; Biomarkers; Diabetes mellitus; Cardiomyopathy

Core Tip: Diabetic cardiomyopathy (DCM), which affects 12% of diabetics, is an under-recognized and lethal complication of diabetes. Thus, there is an urgent need for reliable and available biomarkers for DCM detection. To date, none of the conducted studies have been successful in identifying such biomarkers. Hence, in concordance with current guidelines that accentuate the importance of an interdisciplinary team-based approach, we propose the combination of speckle tracking echocardiography and a few novel biomarkers as a screening method for DCM in patients with new onset diabetes mellitus type 2.