1.4 A PROTEOMIC MARKER OF DIABETIC NEPHROPATHY IS ASSOCIATED WITH MORTALITY IN PATIENTS WITH TYPE 2 DIABETES

DOI

10.1016/j.artres.2017.10.018How to use a DOI?

Abstract

Background: The urinary proteomic classifier CKD273 has been found to predict diabetic nephropathy development in advance of microalbuminuria. Whether it is also a determinant of mortality and cardiovascular disease in patients with established albuminuria is unknown.

Methods: We studied 155 subjects with T2D, albuminuria (geometrical mean [IQR]: 85 [34;194] mg/24 hrs), controlled blood pressure (129 ± 16/74 ± 11 mmHg) and preserved renal function (eGFR 88 ± 17 ml/min/1.73 m²). Blood and urine samples were collected for measurement of estimated glomerular filtration rate (eGFR), urine albumin excretion (UAE), N-terminal pro-brain natriuretic peptide (NT-proBNP) and urinary proteomics (capillary electrophoresis coupled to mass spectrometry). Computed tomography imaging was performed to assess coronary artery calcium (CAC) score. Outcome data were collected through national disease registries over a 6 year follow up period.

Results: CKD273 correlated with UAE (r = 0.481, p = <0.001), age (r = 0.238, p = 0.003), CAC score (r = 0.236, p = 0.003), NT-proBNP (r = 0.190, p = 0.018) and eGFR (r = 0.265, p = 0.001). On multiple regression only UAE (β = 0.402, p < 0.001) and eGFR (β = −0.184, p = 0.039) were statistically significant determinants. Twenty participants died during follow-up. CKD273 was a determinant of mortality (log rank [Mantel-Cox] p = 0.004), and retained significance (p = 0.050) after adjustment for age, sex, blood pressure, NT-proBNP and CAC score in a Cox regression model. Neither eGFR nor UAE were determinants of mortality in this cohort.

Conclusions: A multidimensional biomarker can provide information on outcomes associated with its primary diagnostic purpose. Here we demonstrate that the peptidomics-based classifier CKD273 is associated with mortality in albuminuric people with T2D in even when adjusted for other established cardiovascular and renal biomarkers.

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TY  - JOUR
AU  - Gemma Currie
AU  - Sheon Mary
AU  - Bernt Johan von Scholten
AU  - Morten Kofod Lindhardt
AU  - Harald Mischak
AU  - William Mullen
AU  - Peter Rossing
AU  - Christian Delles
PY  - 2017
DA  - 2017/12/06
TI  - 1.4 A PROTEOMIC MARKER OF DIABETIC NEPHROPATHY IS ASSOCIATED WITH MORTALITY IN PATIENTS WITH TYPE 2 DIABETES
JO  - Artery Research
SP  - 48
EP  - 48
VL  - 20
IS  - C
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2017.10.018
DO  - 10.1016/j.artres.2017.10.018
ID  - Currie2017
ER  -