Article open access publication

Urinary biomarkers are associated with incident cardiovascular disease, all-cause mortality and deterioration of kidney function in type 2 diabetic patients with microalbuminuria

Diabetologia, Springer Nature, ISSN 1432-0428

Volume 59, 7, 2016

DOI:10.1007/s00125-016-3937-0, Dimensions: pub.1047957283, PMID: 27033561,

Authors

Oellgaard, Jens (1) (2) (3)
Rossing, Peter (1) (6) (7)

* Corresponding author

Affiliations

Organisations

  1. (1) Steno Diabetes Center, grid.419658.7, Capital Region
  2. (2) Slagelse Hospital, grid.452905.f, Zealand Region
  3. (3) University of Southern Denmark, grid.10825.3e, SDU
  4. (4) Department of Endocrinology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
  5. (5) Rigshospitalet, grid.475435.4, Capital Region
  6. (6) Aarhus University, grid.7048.b, AU
  7. (7) University of Copenhagen, grid.5254.6, KU

Countries

Denmark

Continents

Europe

Description

AIMS/HYPOTHESIS: We evaluated two urinary biomarkers reflecting different aspects of renal pathophysiology as potential determinants of incident cardiovascular disease (CVD), all-cause mortality and a reduced estimated GFR (eGFR) in patients with type 2 diabetes and microalbuminuria but without clinical features of coronary artery disease. METHODS: In a prospective study of 200 patients, all received multifactorial treatment. Baseline measurements of urinary hepatocyte growth factor (HGF) and adiponectin were available for 191 patients. Cox models were adjusted for sex, age, LDL-cholesterol, smoking, HbA1c, plasma creatinine, systolic BP and urinary AER (UAER). The pre-defined endpoint of chronic kidney disease progression was a decline in the eGFR of >30% during follow-up. HRs per 1 SD increment of log-transformed values are presented. RESULTS: Patients had a mean ± SD age of 59 ± 9 years with a median (interquartile range) UAER of 103 (39-230) mg/24 h. During a median 6.1 years of follow-up, there were 40 incident CVD events, 26 deaths and 42 patients reached the pre-defined chronic kidney disease progression endpoint after 4.9 years (median). Higher urinary HGF was a determinant of CVD in unadjusted (HR 1.9 [95% CI 1.3, 2.8], p = 0.001) and adjusted (HR 2.0 [95% CI 1.2, 3.2], p = 0.004) models, and of all-cause mortality in unadjusted (HR 2.3 [95% CI 1.3, 3.9], p = 0.003) and adjusted (HR 2.5 [95% CI 1.3, 4.8], p = 0.005) models. A higher adiponectin level was associated with CVD in unadjusted (HR 1.4 [95% CI 1.0, 1.9], p = 0.04) and adjusted (HR 1.4 [95% CI 1.1, 2.3], p = 0.013) models, and with a decline in the eGFR of >30% in unadjusted (HR 1.6 [95% CI 1.2, 2.2], p = 0.008) and adjusted (HR 1.5 [95% CI 1.1, 2.2], p = 0.007) models. CONCLUSIONS/INTERPRETATION: In patients with type 2 diabetes and microalbuminuria receiving multifactorial treatment, higher urinary HGF was associated with incident CVD and all-cause mortality, and higher adiponectin was associated with CVD and deterioration in renal function.

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University of Southern Denmark

Aarhus University

University of Copenhagen

Danish Open Access Indicator

2016: Unused

Research area: Medicine

Danish Bibliometrics Indicator

2016: Level 1

Research area: Medicine

Dimensions Citation Indicators

Times Cited: 15

Field Citation Ratio (FCR): 6.55

Relative Citation ratio (RCR): 1.08

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