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

ABSTRACT BACKGROUND Diabetes 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. METHODS We 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. RESULTS The 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). CONCLUSIONS This 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.