Distribution and clinical association of plasma soluble ST2 during the development of type 2 diabetes

Aim: ST2 plays important roles in diabetes and cardiovascular diseases. However, the distribution and changes in plasma soluble ST2 during the development of type 2 diabetes remain unclear. Methods: In the present study, 525 subjects were recruited and divided into three groups: normal, prediabetic and diabetic subjects. The sST2 levels of all subjects were measured using a high-sensitivity assay. Results: sST2 levels were modestly but significantly elevated in patients with diabetes (26.1 ng/ml) compared with normal subjects (19.3 ng/ml, P < 0.001) and persons with prediabetes (20.3 ng/ml, P < 0.001). The third and fourth quartiles (21.3 and 29.1 ng/ml, respectively) of the sST2 levels were associated with a 2.31- and 4.00-fold increased risk of having diabetes. With the prediabetic group as a reference population, patients with sST2 levels in the fourth quartiles had a higher increased risk of having diabetes mellitus (odds ratios = 2.19, P < 0.05). Furthermore, each SD log sST2 was associated with a 1.57-fold increased risk of atherosclerosis when all relevant variables was added to the multi-variable logistic regression models. After adjustment for age and sex, all markers of liver and renal function, HDL-cholesterol, total cholesterol and smoking status showed a significant association with sST2 levels. Conclusion: Elevated sST2 levels were not only associated with metabolic characteristics of diabetes but also with a significantly increased risk of having diabetes. (C) 2016 Elsevier Ireland Ltd. All rights reserved.