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Urinary liver-type fatty acid-binding protein predicts progression to nephropathy in type 1 diabetic patients.

Nielsen SE, Sugaya T, Hovind P, Baba T, Parving HH, Rossing P - Diabetes Care (2010)

Bottom Line: In a Cox regression model, baseline log u-LFABP levels predicted the development of microalbuminuria, adjusted for known risk factors (sex, age, A1C, systolic and diastolic blood pressure, albumin excretion rate, serum creatinine, and smoking) (hazard ratio [HR] 2.3 [95% CI 1.1-4.6]) and log u-LFABP predicted mortality (adjusted HR 3.0 [1.3-7.0]). u-LFABP (above versus below the median) predicted the development of macroalbuminuria (adjusted HR 2.6 [1.2-5.4]).As a continuous variable, u-LFABP tended to predict macroalbuminuria (HR 1.9, P = 0.2), but numbers were small.High levels of the tubular inflammation marker u-LFABP predict the initiation and progression to diabetic nephropathy and all-cause mortality, independent of urinary albumin excretion rate and other established risk factors.

View Article: PubMed Central - PubMed

Affiliation: Steno Diabetes Center, Gentofte, Denmark. sene@steno.dk

ABSTRACT

Objective: Urinary liver-type fatty acid-binding protein (u-LFABP) is a marker of tubulointerstitial inflammation and has been shown to be increased in patients with type 1 diabetes and is further increased in patients who progress to micro- and macroalbuminuria. Our aim was to evaluate u-LFABP as a predictor of progression to micro- and macroalbuminuria in type 1 diabetes.

Research design and methods: From an inception cohort of 277 patients, u-LFABP, adjusted for urinary creatinine (enzyme-linked immunosorbent assay), was measured in 24-h urine samples from 165 normoalbuminuric patients 9.6 +/- 3.5 (mean +/-SD) years after onset of type 1 diabetes. The outcome measured was development of persistent micro- or macroalbuminuria or death.

Results: Patients were followed for a median of 18 (range 1-19) years; 39 progressed to microalbuminuria, 8 of those progressed further to macroalbuminuria, and 24 died. In a Cox regression model, baseline log u-LFABP levels predicted the development of microalbuminuria, adjusted for known risk factors (sex, age, A1C, systolic and diastolic blood pressure, albumin excretion rate, serum creatinine, and smoking) (hazard ratio [HR] 2.3 [95% CI 1.1-4.6]) and log u-LFABP predicted mortality (adjusted HR 3.0 [1.3-7.0]). u-LFABP (above versus below the median) predicted the development of macroalbuminuria (adjusted HR 2.6 [1.2-5.4]). As a continuous variable, u-LFABP tended to predict macroalbuminuria (HR 1.9, P = 0.2), but numbers were small.

Conclusions: High levels of the tubular inflammation marker u-LFABP predict the initiation and progression to diabetic nephropathy and all-cause mortality, independent of urinary albumin excretion rate and other established risk factors.

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Kaplan-Meier plot: elevated baseline u-LFABP levels in 165 normoalbuminuric type 1 diabetic patients predict progression to microalbuminuria. Quartiles with limits: u-LFABP/creatinine: 4.7, 10.9 and 21.3 (pg/ml)/(mg/dl). P = 0.02 for overall difference.
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Figure 2: Kaplan-Meier plot: elevated baseline u-LFABP levels in 165 normoalbuminuric type 1 diabetic patients predict progression to microalbuminuria. Quartiles with limits: u-LFABP/creatinine: 4.7, 10.9 and 21.3 (pg/ml)/(mg/dl). P = 0.02 for overall difference.

Mentions: u-LFABP is reported as a categorical variable in Fig. 2 for the presentation of a Kaplan-Meier plot. Receiver operating characteristic curves were calculated in SPSS 15 (SPSS, Chicago, IL), assuming nonparametric distribution of parameters for SE of area.


Urinary liver-type fatty acid-binding protein predicts progression to nephropathy in type 1 diabetic patients.

Nielsen SE, Sugaya T, Hovind P, Baba T, Parving HH, Rossing P - Diabetes Care (2010)

Kaplan-Meier plot: elevated baseline u-LFABP levels in 165 normoalbuminuric type 1 diabetic patients predict progression to microalbuminuria. Quartiles with limits: u-LFABP/creatinine: 4.7, 10.9 and 21.3 (pg/ml)/(mg/dl). P = 0.02 for overall difference.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2875447&req=5

Figure 2: Kaplan-Meier plot: elevated baseline u-LFABP levels in 165 normoalbuminuric type 1 diabetic patients predict progression to microalbuminuria. Quartiles with limits: u-LFABP/creatinine: 4.7, 10.9 and 21.3 (pg/ml)/(mg/dl). P = 0.02 for overall difference.
Mentions: u-LFABP is reported as a categorical variable in Fig. 2 for the presentation of a Kaplan-Meier plot. Receiver operating characteristic curves were calculated in SPSS 15 (SPSS, Chicago, IL), assuming nonparametric distribution of parameters for SE of area.

Bottom Line: In a Cox regression model, baseline log u-LFABP levels predicted the development of microalbuminuria, adjusted for known risk factors (sex, age, A1C, systolic and diastolic blood pressure, albumin excretion rate, serum creatinine, and smoking) (hazard ratio [HR] 2.3 [95% CI 1.1-4.6]) and log u-LFABP predicted mortality (adjusted HR 3.0 [1.3-7.0]). u-LFABP (above versus below the median) predicted the development of macroalbuminuria (adjusted HR 2.6 [1.2-5.4]).As a continuous variable, u-LFABP tended to predict macroalbuminuria (HR 1.9, P = 0.2), but numbers were small.High levels of the tubular inflammation marker u-LFABP predict the initiation and progression to diabetic nephropathy and all-cause mortality, independent of urinary albumin excretion rate and other established risk factors.

View Article: PubMed Central - PubMed

Affiliation: Steno Diabetes Center, Gentofte, Denmark. sene@steno.dk

ABSTRACT

Objective: Urinary liver-type fatty acid-binding protein (u-LFABP) is a marker of tubulointerstitial inflammation and has been shown to be increased in patients with type 1 diabetes and is further increased in patients who progress to micro- and macroalbuminuria. Our aim was to evaluate u-LFABP as a predictor of progression to micro- and macroalbuminuria in type 1 diabetes.

Research design and methods: From an inception cohort of 277 patients, u-LFABP, adjusted for urinary creatinine (enzyme-linked immunosorbent assay), was measured in 24-h urine samples from 165 normoalbuminuric patients 9.6 +/- 3.5 (mean +/-SD) years after onset of type 1 diabetes. The outcome measured was development of persistent micro- or macroalbuminuria or death.

Results: Patients were followed for a median of 18 (range 1-19) years; 39 progressed to microalbuminuria, 8 of those progressed further to macroalbuminuria, and 24 died. In a Cox regression model, baseline log u-LFABP levels predicted the development of microalbuminuria, adjusted for known risk factors (sex, age, A1C, systolic and diastolic blood pressure, albumin excretion rate, serum creatinine, and smoking) (hazard ratio [HR] 2.3 [95% CI 1.1-4.6]) and log u-LFABP predicted mortality (adjusted HR 3.0 [1.3-7.0]). u-LFABP (above versus below the median) predicted the development of macroalbuminuria (adjusted HR 2.6 [1.2-5.4]). As a continuous variable, u-LFABP tended to predict macroalbuminuria (HR 1.9, P = 0.2), but numbers were small.

Conclusions: High levels of the tubular inflammation marker u-LFABP predict the initiation and progression to diabetic nephropathy and all-cause mortality, independent of urinary albumin excretion rate and other established risk factors.

Show MeSH
Related in: MedlinePlus