# A Retrospective Assessment of Changes in Stroke Risk-Related Biomarkers in Individuals with Prediabetes from Durban, South Africa: Preliminary Findings

## TL;DR

This study found that people with prediabetes in Durban, South Africa, have higher levels of biomarkers linked to stroke risk compared to those without prediabetes.

## Contribution

The study is one of the first to assess stroke-related biomarkers in prediabetic individuals from South Africa, highlighting S100B as a potential early indicator.

## Key findings

- Prediabetic individuals showed significantly higher concentrations of stroke-related biomarkers compared to non-prediabetic controls.
- S100B levels strongly correlated with HbA1c and fasting glucose, suggesting a link between metabolic dysfunction and stroke risk.
- Biomarker levels increased further in individuals with type 2 diabetes compared to prediabetic and non-prediabetic groups.

## Abstract

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder that significantly increases the risk of stroke, with prediabetes serving as an intermediate stage marked by similar pathophysiological mechanisms such as inflammation and vascular dysfunction. This study investigated the relationship between prediabetes and stroke-related biomarkers in individuals aged 25–45 years in Durban, South Africa. After obtaining ethical approval, a retrospective analysis was performed on blood samples from 100 participants recruited from King Edward Hospital and Inkosi Albert Luthuli Central Hospital. Participants were classified as non-prediabetic (n = 30), prediabetic (n = 35), or type 2 diabetic (n = 35) according to ADA criteria. Plasma concentrations of C-reactive protein (CRP), interleukin-6 (IL-6), fibrinogen, D-dimer, calcium binding protein (S100B), glial fibrillary acidic protein (GFAP), and neuron-specific enolase (NSE) were measured using enzyme-linked immunosorbent assay (ELISA). It is important to note that none of the participants had confirmed stroke events; these biomarkers were assessed as surrogate indicators of stroke risk. Statistical analyses included one-way ANOVA with Tukey–Kramer tests and Pearson’s correlations. Biomarker concentrations were significantly elevated in prediabetic individuals compared to non-prediabetic controls, with levels further increasing in T2DM. Strong positive correlations were observed between S100B and both HbA1c (r = 0.75, p < 0.0001) and fasting glucose (r = 0.75, p < 0.0001). These findings suggest that inflammatory, coagulation, and neurovascular biomarkers, particularly S100B, may indicate early stroke risk in prediabetes. Further investigation into these biomarkers could improve early detection strategies and stroke prevention efforts in at-risk populations.