456-P: Ceramide- and Phosphatidylcholine-Based Coronary Event Risk Tests 1 and 2 (CERT1, CERT2) Predict Both Type 2 Diabetes and Chronic Kidney Disease

The ceramide- and phosphatidylcholine-based scores CERT1 and CERT2 are predictors for cardiovascular events. The presence of chronic kidney disease (CKD) indicates a high risk of cardiovascular events, particularly in patients who also have type 2 diabetes (T2DM). However, little is known about the associations between T2DM, CKD and CERT1 or CERT2. Therefore, we determined CKD status (eGFR <60 ml/min. 1,73 m² or albuminuria with an albumin/creatinine ratio >30 mg/g) and analyzed CERT1/2 in 945 high-risk patients, of whom 259 had T2DM. T2DM was diagnosed using ADA criteria. Both CERT1 and CERT2 were significantly higher in patients with T2DM than in nondiabetic subjects (4.5±3.4 vs. 3.5±2.9;p<0.001 and 5.9±2.6 vs. 5.2±2.3; p<0.001, respectively). Further, CERT1 and CERT2 predicted T2DM after adjusting for age, sex, smoking, BMI, LDL-C, HDL-C, with ORs of 1.10 [1.05-1.15]; p<0.001 and 1.10 [1.03-1.17]; p=0.004, respectively. CKD was present in 52.5% of our patients with T2DM and in 30.3% of nondiabetic subjects (p<0.001). CERT1 predicted the risk of CKD in patients with T2DM as well as in patients who did not have T2DM (with ORs of 1.11 [1.03-1.20]; p=0.005 and 1.10 [1.04-1.17]; p=0.001; respectively), as did CERT2 (ORs 1.16 [1.05-1.29]; p=0.005 and 1.14 [1.06-1.24]; p<0.001; respectively). We conclude that CERT1 and CERT2 are strong and significant predictors of T2DM as well as of CKD.