P61: Race and Diurnal Variability of Biomarkers for Diabetes and Cardiovascular Disease
Poster Presenter
Jorg Taubel
Chief Executive Officer
Richmond Pharmacology United Kingdom
Objectives
The objective is to examine diurnal and racial variations in commonly used diagnostic biomarkers for diabetes and cardiovascular disease.
Method
Samples from 6449 healthy volunteers, aged 18-76, who were trial participants at a UK clinical research organisation were analysed for seven diagnostic biomarkers for diabetes and cardiovascular disease.
Results
Patient samples were categorised as Asian, Black and Caucasian. All samples were taken between 8.00 and 18.00. All data was anonymised and taken from individuals who had given their informed consent to have their data used this study. The seven biomarkers were fasting blood glucose, c-reactive protein, fasting triglycerides, fasting total cholesterol, HDL cholesterol, fasting LDL cholesterol and thyroid stimulating hormone.
Significant racial and diurnal variations were identified. Black volunteers had significantly lower fasting blood glucose levels than both Asians and Caucasians. Black volunteers also had the most significant decrease in fasting blood glucose when comparing the afternoon to the morning. Fasting triglyceride levels and fasting total cholesterol levels were significantly lower for Black volunteers compared to Asians and Caucasians. Differences in HDL cholesterol, fasting LDL cholesterol, c-reactive protein and thyroid stimulating hormone levels were insignificant, though this is potentially due to insufficient sample sizes.
Conclusion
Diabetes and cardiovascular disease are two diseases with overlapping aetiologies for which large numbers of people remain undiagnosed in the UK. Diagnosis for these diseases requires quantification of diverse biomarkers, for which there are known diurnal and racial variation. In spite of this, the diagnostic thresholds for these biomarkers have no diurnal or racial modifiers; they are constant, regardless of patient demographic or time of testing. This has the potential to lead to systemic mis- or underdiagnosis.
Our results suggest that the use of universal thresholds for fasting blood glucose and fasting triglycerides may be inappropriate and may contribute to underdiagnosis of diabetes and cardiovascular disease in some demographics.
