Utilization of Electronic Health Records for the Assessment of Adiponectin Receptor Autoantibodies during the Progression of Cardio-metabolic Comorbidities

BACKGROUNDDiabetes is a complex, multi-symptomatic disease that drives healthcare costs through its complications as the prevalence of this disease grows rapidly world-wide. Real-world electronic health records (EHRs) coupled with patient biospecimens, biological understanding, and technologies can lead to identification of new diagnostic markers. METHODSWe analyzed the 20-year EHRs of 1862 participants with midpoint samples (10-year) in an observational study of type 2 diabetes and cardiovascular arterial disease (CVAD) conducted by the Fairbanks Institute to test the diagnostic biomarkers. Participants were assigned to four cohorts (healthy, diabetes, CVAD, CVAD+diabetes) based on EHR data analysis. The immunoassay reference range for circulating autoantibodies against the C-terminal fragment of adiponectin receptor 1 (IgG-CTF) was determined and used to predict outcomes post-sample. RESULTSThe IgG-CTF reference range was determined [75-821 ng/mL] and out-of-range values of IgG-CTF values predicted increased likelihood of additional comorbidities and mortality determined from the EHRs 10 years after sample collection. The probability of mortality was lower in patients with elevated IgG-CTF >821 ng/mL [OR 0.49-0.0] and higher in patients with lowered IgG-CTF <75 ng/mL [OR 3.74-9.64]. Although many patients at the time of sample collection had other conditions (hypertension, hyperlipidemia, or elevated uristatin values), only hypertension correlated with increased likelihood of mortality (OR 4.36-5.34). CONCLUSIONSThis study confirms that retrospective analysis of biorepositories coupled with EHRs can provide insight into novel diagnostic markers and the IgG-CTF marker can predict the likelihood of progressing to additional comorbidities or mortality.