BNP, Corin and Furin as Potential Biomarkers for Cardiovascular Complications in Type 2 Diabetes Mellitus Patients

The number of patients with type 2 diabetes mellitus (T2DM) is progressively increasing, and diabetic cardiovascular complications have become a public health problem. Brain or B-type natriuretic peptide (BNP) is a cardiac hormone synthesized as a pre-pro-peptide. Pro-BNP is produced by cleaving the signal peptide then two proprotein convertases, corin and furin cleave pro-BNP to form a biologically active hormone. Two corin single nucleotide polymorphisms (SNPs) have been reported to alter corin protein conformation and impair its biological activity. We aimed to investigate the potential role of corin and furin in comparison to BNP as biomarkers for predicting cardiovascular complications in T2DM patients. The association of corin gene SNPs with corin levels was also examined. Seventy-five subjects were recruited in this study, including 25 T2DM patients with complications, 25 T2DM patients without complications as well as 25 healthy subjects. Plasma BNP, corin and furin levels were measured using enzyme-linked immunosorbent assay. Two corin SNPs were genotyped using allele specific oligonucleotide-polymerase chain reaction. Both furin and BNP were found to be more sensitive than corin (80% vs. 56%, P=0.008), whereas furin showed higher specificity when compared to BNP (96% vs. 84%, P=0.041) and corin (96% vs. 64%, P<0.0001) in predicting cardiovascular complications in T2DM patients. Corin SNPs are not associated with corin levels in the study cohort (P>0.05). In conclusion, furin may be useful, either alone or in combination with other biomarkers, for cardiovascular risk stratification assessment in T2DM patients.