Abstract
Introduction: High-sensitivity cardiac troponin (hs-cTnT) is a marker of myocardial damage and has been associated with diabetes and its major complications, particularly those with a microvascular etiology. The aim of this study was to assess the association of hs-cTnT and other cardiac, kidney, inflammation, and hyperglycemia biomarkers with peripheral neuropathy (PN) in both diabetic and non-diabetic populations. Methods: We conducted a cross-sectional analysis of 3,019 black and white participants in the ARIC study who underwent monofilament PN testing and had hs-cTnT and other nontraditional measures [NT-proBNP, high-sensitivity C-reactive protein, β-2 microglobulin, creatinine-based estimated glomerular filtration rate (eGFR), cystatin C-based eGFR, urine albumin:creatinine ratio, fructosamine, glycated albumin, and 1,5-anhydroglucitol] assessed at ARIC visit 6 (2016-2017, age 71-94 years). We used logistic regression models to assess the associations of these biomarkers with the presence of PN in older adults with and without diabetes after adjusting for traditional diabetes and cardiovascular risk factors. Results: Overall, 38.0% of the 3,019 participants had evidence of PN (42.0% in persons with diabetes and 36.4% in persons without diabetes). After adjusting for traditional risk factors, there were significant and robust associations of hs-cTnT, NT-proBNP, and β-2 microglobulin with PN ( Table, Model 2 ). After further adjusting for hemoglobin A1c, only the association of hs-cTnT with PN remained significant (P=0.02; Model 3 ). Elevated hs-cTnT (≥14 ng/L) was associated with prevalent PN in persons with diabetes (OR 2.10, 95%CI 1.24-3.56) and without diabetes (OR 2.61, 95% CI 1.59-4.28) compared to persons without diabetes and non-elevated hs-cTnT (<6 ng/L). Conclusions: Hs-cTnT is associated with the presence of PN in older adults independent of cardiovascular risk factors and glycemic control. These findings support the hypothesis that hs-cTnT may be a global marker of end organ damage.
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