A comprehensive analysis of 30 Biomarkers and their association with cardiovascular outcomes and mortality in the UK Biobank

Abstract

Abstract Background The use of a comprehensive panel of circulating biomarkers in risk estimation of cardiovascular disease and mortality in a general healthy population remains uncertain. Methods The individual association of 30 clinically available biomarkers with risk of incident heart failure (HF), atrial fibrillation (AF), stroke, myocardial infarction (MI), venous thromboembolism (VTE), and mortality was estimated within 5-years using separate logistic regression models in nearly 500,000 individuals in the UK Biobank; a prospective, population-based cohort recruited between 2006-2010. Results A total of 496,415 individuals were included (median age 58 years, 54% female). Higher concentrations of C-reactive protein, gamma-glutamyl transferase, cystatin C, and urate were associated with significantly higher odds, and albumin with lower odds, of all outcomes (Figure 1). Higher levels of sex hormone binding globulin were associated with a higher risk of AF for both sexes (men: Odds ratio [OR] per standard deviation [SD] 1.26, 95% confidence intervals [CI] 1.21-1.31; premenopausal women: OR per SD 1.20, 95% CI 1.09-1.31; postmenopausal women: OR per SD 1.41, 95% CI 1.12-1.77). No significant associations were found among pre- or postmenopausal women between estradiol and cardiovascular outcomes. For men, having estradiol ≥40 pmol/L was associated with a higher risk of mortality, HF and AF. Conclusions Several associations were found between multiple biomarkers and cardiovascular disease, and mortality, especially novel associations of hormonal markers associated with both lower and higher odds of cardiovascular disease. Further research is needed to validate these associations and explore the potential clinical applications of biomarker data.