The University of Texas Medical Branch at Galveston
08/14/2026 | Press release | Distributed by Public on 08/14/2026 06:58
UTMB study finds a form of inflammation that current diabetes and heart treatments do not reach
UTMB study finds a form of inflammation that current diabetes and heart treatments do not reach
August 14, 2026 • 7:42 a.m. by Staff
Many people with Type 2 diabetes continue to face an elevated risk for heart attacks, strokes, and death even after receiving recommended treatment for diabetes and heart disease, according to a study led by researchers at The University of Texas Medical Branch (UTMB) and published in Diabetes Care.
Researchers found that while a common marker of inflammation improved significantly with treatment, a second marker called suPAR did not. Patients with elevated suPAR levels remained at increased risk for cardiovascular events and death regardless of the therapies they received.
The findings suggest that some patients carry an underlying form of inflammation that current therapies do not address and that standard blood tests may miss.
For years, doctors have used a blood test called hs-CRP to measure inflammation associated with heart disease. It responds well to treatment, and in this study levels fell by about 28% after one year. But suPAR, which reflects a different type of inflammation, did not decline in any treatment group and instead rose slightly across all groups.
"Many patients do everything right. They take their medications, manage their diabetes, and follow their treatment plans, yet they still experience serious cardiovascular problems," said Salim Hayek, MD, a cardiologist and chair of the Department of Internal Medicine at UTMB.
"In our research, we studied patients with diabetes who were treated aggressively for their heart and cholesterol problems and found that despite that treatment, their hs-CRP levels went down, but suPAR levels actually rose," Hayek said. "That tells us the risk carried by suPAR has not been addressed. There is still residual inflammation contributing to that risk."
He said that even when traditional risk factors are controlled, many patients with diabetes remain at significantly higher cardiovascular risk than people without diabetes.
"Higher suPAR levels appear to identify an important part of that remaining risk," he said.
Researchers analyzed data and blood samples from more than 2,200 participants in BARI 2D, a large national trial of people living with both Type 2 diabetes and coronary artery disease. Participants were randomly assigned to different diabetes medications and heart disease management strategies, allowing the team to evaluate whether any of those approaches changed suPAR levels.
The UTMB team obtained the samples and data through the National Heart, Lung, and Blood Institute's BioLINCC repository. The analysis was led by Anis Ismail, MD, a postdoctoral fellow at UTMB, with collaborators from the University of Michigan, the University of Pittsburgh, Oregon Health & Science University, Emory University, and AdventHealth.
After one year, hs-CRP levels had fallen by about 28%. In contrast, suPAR levels did not fall in any treatment group and instead rose slightly across all of groups. The treatment patients received made no difference.
Patients with higher suPAR levels faced a significantly greater risk of death, heart attack, or stroke during follow-up, and that risk persisted even after accounting for hs-CRP. Even among patients whose hs-CRP returned to normal, those with elevated suPAR remained at increased risk.
The findings suggest that measuring suPAR alongside existing tests could help doctors identify patients who may benefit from closer monitoring or new treatment approaches.
"Inflammation is not a single process. It is a complex network of biological pathways, and hs-CRP captures only part of that picture," Hayek said. "Our findings show that suPAR reflects a different part of the immune system, one that conventional therapies do not appear to reach and that hs-CRP does not capture."
In light of recent clinical trials showing that lowering hs-CRP alone does not necessarily improve outcomes, Hayek said these results point to suPAR as a promising biomarker for identifying patients who remain at risk and may benefit from new therapies currently in development.
Researchers say additional studies are needed to determine whether therapies that specifically target the biological processes reflected by suPAR can reduce cardiovascular risk.
"UTMB has been at the forefront of suPAR research and, to my knowledge, is the first institution in the United States to bring suPAR testing into clinical practice," Hayek said. "This study helps establish suPAR as a tool for identifying residual inflammatory risk and provides a foundation for evaluating future therapies designed to target that pathway."
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