What blood proteins might help predict disease progression in people with cardiometabolic conditions?
In people with cardiometabolic conditions such as diabetes, hypertension, and dyslipidemia, certain blood proteins can signal a higher risk of disease progression. These proteins are measurable in plasma and may help doctors predict who is more likely to develop complications like heart disease or kidney problems. Research has identified several promising protein markers, including GDF15, ADM, PCSK9, HS-CRP, and members of the S100 family.
What the research says
A large study using UK Biobank data found that plasma proteins can mediate the link between primary cardiometabolic diseases (diabetes, hypertension, dyslipidemia) and secondary conditions like cardiovascular and kidney disease. For example, GDF15 consistently mediated the diabetes-to-cardiovascular disease pathway, and ADM mediated the hypertension-to-pulmonary disease pathway. Including these proteins improved prediction accuracy for secondary disease risk by up to 14% compared to traditional risk factors 5.
Another study in patients with stable coronary artery disease showed that low levels of PCSK9 and high levels of high-sensitivity C-reactive protein (HS-CRP) independently predicted progression of aortic stenosis over a median follow-up of 72 months 10. This suggests that these proteins may help identify patients at risk for worsening heart valve disease.
S100 proteins (S100A8, S100A9, S100A12) are released from cells in response to stress and promote inflammation in the arterial wall. They bind to receptors like RAGE and TLR4, activating pathways that contribute to atherosclerosis progression 9. These proteins are linked to vascular inflammation, calcification, and oxidative stress, making them potential markers for disease worsening.
In the context of dyslipidemia, the FDA has recognized high-sensitivity C-reactive protein (hsCRP) ≥2 mg/L as a risk factor for cardiovascular events in adults without established heart disease 1. This highlights the role of inflammatory proteins in predicting outcomes.
What to ask your doctor
- Could measuring proteins like GDF15, ADM, or PCSK9 in my blood help assess my risk of heart or kidney disease?
- Is high-sensitivity C-reactive protein (hs-CRP) testing available and would it be useful for my condition?
- Are there any S100 protein tests that could indicate inflammation in my arteries?
- How do these protein markers compare with traditional risk factors like cholesterol and blood pressure in predicting my disease progression?
- Should I consider having my plasma protein levels checked regularly to monitor my cardiometabolic health?
This question is drawn from common patient questions about this topic and answered using cited medical research. We do not provide individualized advice.