Table 1.
Relevant literature and efficacy analysis of biomarker combined diagnosis.
| Type of study | Study group and subjects | Detection indicators | Results | Author, country, year. |
|---|---|---|---|---|
| Animal experimental study | T2DM group (db/db mice); N = 40; Age: 6–16 weeks Control group (db/+ mice); N = 40; Age: 6–16 weeks |
LOXL2 and ETFβ | In db/db mice, the combined detection of elevated serum LOXL2 levels and decreased serum ETFβ levels demonstrated superior predictive efficacy (AUC = 0.813), outperforming single indicators alone. | Johnson et al. (59), South Africa, 2020 |
| Review | None | ANGPTL4 and LPL | Maintaining the balance of LPL and ANGPTL4 levels is crucial for preventing DCM lesions, and their combined detection helps in early problem identification. | Puthanveetil et al. (60), Canada, 2015 |
| Cross-sectional study | T2DM group; N = 78; age: 45–65 yr Control group; N = 12; age: 45–65 yr |
miR-1, miR-133a | 1. The levels of miR-1 and miR-133a were positively correlated with myocardial fat deposition (r = 0.68, p < 0.001). 2. The diagnostic efficacy (AUC = 0.89) of miR-1/miR-133a combined with HbA1c for myocardial fat deposition was significantly higher than that of the single-index. |
De Gonzalo - Calvo et al. (61), Spain, 2016 |
| Cross-sectional study | DCM group; N = 49; age: 56.33 ± 8.19 yr; T2DM group; N = 49; age: 53.35 ± 8.29 yr |
miR-21, HbA1c, DM duration, and blood lipid levels | Combining miR-21, DM duration, HbA1c%, and blood lipid indices achieves the highest diagnostic efficiency (AUC = 0.939). | Tao et al. (62), China, 2000 |
| Cross-sectional study | DCM group; N = 92; age: 60.18 ± 12.26 yr T2DM group; N = 105; age: 57.50 ± 15.02 yr |
Butyric acid and the methylation status of 7 CpG sites in intron 1 of HIF3A | The AUC of combining butyric acid with CpG-6 methylation reached 0.737, which was superior to that of the single-index. | Guo et al. (63), China, 2021 |
| Cross-sectional study | T2DM group; N = 60; age: 45–65 yr Control group; N = 40; age: 45–65 yr |
MMPs and TIMPs | In patients with DM complicated with LVDD, the levels of MMP-9 and MMP-7 in plasma were elevated, and the ratio of TIMP-1 to MMP-9 was decreased. | Ban et al. (64), Australia, 2010 |
| Cross-sectional study | DM-DD group; N = 47; age: 45–65 yr Simple DM group; N = 34; age: 45–65 yr |
TNF-α, INS, AGEs, Cr | 1.INS ≥22.7, TNF-α ≥3.9, AGEs ≥11.6, and Cr ≥1.1 are important predictive factors for distinguishing DM-DD from DM-N. 2.Combined markers (TNF-α + INS + AGEs + Cr) exhibit an AUC of 0.913 and a specificity of 100%. |
Abdelrahman et al. (65), Egypt, 2021 |
| Cross-sectional study | DM-DD group; N = 47; age: 45–65 yr DM-SD group; N = 32; age: 45–65 yr |
IL-6, AGEs | 1. AGEs ≥14.2 and IL-6 ≥6.4 are important predictive factors for distinguishing DM-SD from DM-DD. 2.Combined markers (IL-6 + AGEs) exhibit an AUC of 0.796 and a sensitivity of 90.6%. |
Abdelrahman et al. (65), Egypt, 2021 |
| Cross-sectional study | DCM (DM-DD + DM-SD) group; N = 79; age: 45–65 yr DM-N group; N = 34; age: 45–65 yr |
TNF-α, IL-6, AGEs | 1.TNF-α ≥1.7, AGEs ≥11.4, and IL-6 ≥3.5 are important predictive factors for distinguishing DCM from DM-N. 2. Combined markers (TNF-α + IL-6 + AGEs) exhibit an AUC of 0.924, a sensitivity of 84.8%, and a specificity of 88.2%. | Abdelrahman et al. (65), Egypt, 2021 |
| Cohort study | DM-HF group; N = 385; age: 67.8 ± 10.3 yr Non-DM-HF group; N = 684; age: 65.3 ± 14 yr |
sST2 and hs-cTnT | Combined detection of sST2 and hs-cTnT in plasma improves the diagnostic efficacy of clinical outcomes in HF patients with and without DM (AUC = 0.811) and is significantly superior to single markers. | Alonso et al. (66), Spain, 2016 |
| Cohort study | DM group; N = 2266; age: average 57 yr Prediabetic group; N = 4533; age: average 57 yr |
hs-cTnT, NT-proBNP, hs-CRP, LVH | Based on a simple integer score of hs-cTnT, NT-proBNP, hs-CRP, LVH, it can effectively stratify the heart failure risk in patients with diabetes and prediabetes. | Pandey et al. (67), USA, 2021 |
| Cross-sectional study | DM-mdEF group; N = 14; age: 55.42 ± 8.51 yr DM-pEF group; N = 76; age: 55.25 ± 10.62 yr Control group; N = 31; age: 50.89 ± 9.66 yr |
Gal-3 level, GLS | Galectin-3 > 2.71 ng/ml + GLS < -18%: The sensitivity for diagnosing LVDD is 85%, the specificity is 81%, and the negative predictive value (NPV) is 97%, suggesting that combined detection can effectively exclude low-risk populations. | Flores - Ramirez R et al. (68), Mexico, 2017 |
| Cohort study | T1DM patients; N = 960; age: average 48 yr | NT-proBNP, echocardiographic index (E/e’) | Patients with NT-proBNP > 300 pg/mL and E/e’ > 12 have a cardiovascular risk incidence of 115 cases per 1000 person-years, which is 23 times that of the low-risk group (NT-proBNP < 150 pg/mL and E/e’ < 8). | Rørth et al. (69), Denmark, 2020 |