Elevated Free Light Chains Predict Poor CVD Outcomes in Diabetics

ATLANTA—Elevated combined serum free light chains (cFLC) are associated with adverse cardiovascular disease (CVD) outcomes in patients with type 2 diabetes, according to a study presented at the American Society of Nephrology's Kidney Week 2013 meeting.

Srikanth Bellary, MD, of the Heart of England NHS Foundation Trust in Birmingham, and colleagues studied 352 South Asian patients with type 2 diabetes. They compared their condition with other clinical measurements, treatment and prior history of CVD.

Twenty-nine patients (8%) experienced CVD events and cFLC was significantly elevated in these patients compared with those who had no events (50.7 vs. 42.8 mg/L). Results showed that a cFLC level greater than 57.2 mg/L was independently associated with a 3.3 times increased risk for adverse CVD outcomes, even after adjusting for age, albumin-creatinine ratio, duration of diabetes, and treatment. Other factors independently and significantly associated with CVD events included triglyceride levels above 6.7 mmol/L and systolic blood pressure (SBP) greater than 155 mm Hg.

The researchers found no significant difference in high-sensitivity C-reactive protein levels in either group.

Additionally, elevated cFLC, SBP, or triglycerides identified 45%, 41%, and 21% of patients with adverse CVD outcomes, respectively. Seventy-nine percent of subjects who had an adverse CVD event were abnormal for at least one of these risk factors.

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