MiR- 126 can tell heart risk & diabetes early

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Predicting your risk for heart disease and diabetes may become easier and quicker. Scientists in the UK are developing a new test which will predict one's risk for heart disease and diabetes up to 10 years in advance. Currently, there is no test which can predict this risk accurately. The test is expected to be available in just five years and will cost only 2 in the UK (around Rs.145 at current exchange rates). The research has been funded by the British Heart Foundation. The test measures levels of small strands of genetic material called MiR- 126, or micro RNA 126, which plays a crucial role in keeping blood vessels healthy. Its levels fall when the blood vessels are damaged. Scientists at the King's College in London have shown that people with very low levels of MiR- 126 are twice as likely to develop heart disease in the next 10 years. Low levels of this component are also an indicator of the risk of diabetes. A low- cost test which can predict the risk for heart disease and diabetes, two of the biggest killers, will revolutionise the diagnosis and treatment for both. Anyone who is found to be at high risk could then be initiated into taking steps to reduce their risk, according to scientists. The incidence of heart disease and disease of blood vessels is gaining epidemic proportions in India. At present, between 20 and 25 per cent of all hospital admissions and 25 per cent of all mortality is due to heart disease, according to the Union health ministry. Population surveys have reported a nine- fold increase in the prevalence of heart disease. Deaths caused by heart disease will double by 2015. India is already leading the world in the number of diabetics. According to the World Health Organization, the number of diabetics in the world was 171 million in 2000. This number is expected to more than double to 336 million by 2030. In 2000, India topped the list with 31 million diabetics; China had 21 million and the US 17 million. India is expected to have 79 million diabetics by 2030. However, currently, the research related to the new test is preliminary and the technique needs to be refined. But a basic testing kit could be in widespread use by 2015, the study's lead scientist Dr Manual Mayr said. Doctors say that though a person's blood pressure, cholesterol level, smoking habits and weight give an idea of his/ her heart health, the results are not completely reliable.

Two patients might be judged to be at the same risk of problems because they both have high blood pressure and cholesterol, but only one may go on to suffer a heart attack. Then, some patients may appear completely healthy right until the moment they suffer a heart attack. The blood test would pick up signs of damage in their arteries, allowing them to start on drugs and make changes to their lifestyle. Scientists in India are cautious about commenting on the test unless it becomes clinically available. "It is still at the experimental level. We have seen so many molecules based on blood cholesterol or genetic components for predicting heart disease in the past 10 years. But nothing seems to predict the risk accurately," said Dr Rakesh Yadav, a cardiologist at the All India Institute of Medical Sciences ( AIIMS). He said extensive studies are required before it becomes available. He added: "However, if such a test becomes a reality, it would be very important for India as we are genetically prone to heart disease, hypertension and diabetes. Any tool that accurately predicts the risk is useful as then we can strictly modify lifestyle and guide therapy," Yadav said. Patients found at risk could be asked to keep obesity in check by exercising. Repeated sugar monitoring can also be done for those found at risk of diabetes. The test needs proper validation, Dr Anoop Misra, a diabetologist at Fortis Hospital, said. "However, if it has good predictive value and specificity, it could benefit nearly 100 million Indians who are at risk of diabetes and heart disease," he said. "Preventive strategies could be applied early to prevent both conditions. It would also be useful to predict diabetes in two subgroups - those without family history and pregnant women." Diabetes and heart disease cause an enormous economic burden for families. Studies in India estimate that, for a low- income family with an adult with diabetes, as much as 25 per cent of family income may be spent on diabetes care. As a diabetes patient progresses in life, he/ she will have more complications such as heart attack or a stroke or kidney failure or blindness, which will require more complicated and expensive treatment.