Researchers have found blood-based epigenetic markers that may help predict heart disease risk in type 2 diabetes, offering a potential path to more personalized prevention and care.
Abstract
An international research team led by Lund University Diabetes Centre has discovered blood-based epigenetic markers that may help predict which people with type 2 diabetes are at risk of serious cardiovascular events. In a study of 752 newly diagnosed participants followed for just over seven years, a scoring tool based on DNA methylation patterns outperformed standard clinical risk calculators, particularly in ruling out low-risk individuals. While further validation is needed, this approach could lead to a simple blood test that supports more personalized prevention and treatment strategies in type 2 diabetes care.
Key Points
- Study Scope: Followed 752 newly diagnosed type 2 diabetes patients for an average of 4 years, identifying 102 major cardiovascular events.
- Main Finding: Developed a DNA methylation-based score using 87 sites that predicted heart risk more accurately than standard clinical risk scores.
- Low-Risk Identification: The tool had a 96% probability of correctly identifying those unlikely to develop cardiovascular disease.
- Limitations: Short follow-up period, limited diversity, moderate positive predictive value, and missing lifestyle data.
- Future Potential: Could evolve into a simple blood test to guide personalized prevention, treatment, and follow-up in type 2 diabetes.
Researchers at Lund University Diabetes Centre have found promising evidence that tiny chemical changes to DNA—known as epigenetic markers—could help predict which people with type 2 diabetes are most likely to face serious heart problems. Their work, published in Cell Reports Medicine, suggests that a simple blood test may one day guide more personalized prevention and treatment.
What the Study Found
An international team led by Lund University Diabetes Centre has identified epigenetic biomarkers—chemical changes to DNA called DNA methylation—that may predict the risk of serious cardiovascular events in people with type 2 diabetes.
People with type 2 diabetes face up to four times the risk of heart attacks, strokes, angina, and other heart-related conditions compared to those without diabetes. Current risk calculators rely on factors such as age, blood pressure, cholesterol, and long-term blood sugar, but these often fail to clearly distinguish between high- and low-risk individuals.
In this study, researchers followed 752 newly diagnosed participants for just over seven years. None had cardiovascular disease at the start, but 102 developed major heart problems during follow-up. Blood analysis revealed over 400 DNA methylation sites linked to future cardiovascular events. The researchers built a scoring tool based on 87 sites, which outperformed standard clinical risk scores.
This score was particularly strong at ruling out risk, with a 96% probability of correctly identifying those unlikely to develop cardiovascular disease.
Limitations to Consider
While results are promising, the research team notes several important limitations:
- Short follow-up period for a condition that can take many years to develop, which may limit the accuracy of predicting who will experience events.
- Moderate positive predictive value—the ability to correctly identify people who will develop cardiovascular disease—partly due to the low number of events during the study.
- Limited diversity in the study population; findings need testing in different ethnic and demographic groups.
- Some potentially relevant lifestyle factors, such as physical activity and diet, were not measured in this study.
What the Future Holds
Professor Charlotte Ling, a pioneer in diabetes epigenetics research, says the ultimate aim is to develop a simple blood test that measures DNA methylation to give a personalized risk score. If confirmed by longer-term and broader studies, this could be a valuable tool in precision medicine for type 2 diabetes—helping doctors:
- Target preventive strategies, such as dietary changes, exercise programs, and medication, to those most at risk.
- Reduce unnecessary intensive follow-up for people at low risk, saving both time and healthcare resources.
Further research will focus on:
- Validating the tool in larger and more diverse populations.
- Tracking results over longer periods to improve the ability to predict who will have events.
- Refining the scoring system to increase its positive predictive value.
Potential Impact on Diabetes Care
While more research is needed, this study offers a glimpse of how epigenetic testing could change the way heart risk is assessed in type 2 diabetes. If future studies confirm these findings, a quick blood test could become an important tool for tailoring prevention, treatment, and follow-up—helping protect heart health from the moment of diagnosis.
For more information, please visit Cell Reports Medicine or Lund University Diabetes Centre LUDC.
