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- Title
Urine Proteome Specific for Eye Damage Can Predict Kidney Damage in Patients With Type 2 Diabetes: A Case-Control and a 5.3-Year Prospective Cohort Study.
- Authors
Jin-Kui Yang; Ying-Ying Wang; Chang Liu; Ting-Ting Shi; Jing Lu; Xi Cao; Fang-Yuan Yang; Jian-Ping Feng; Chen Chen; Li-Nong Ji; Aimin Xu; Yang, Jin-Kui; Wang, Ying-Ying; Liu, Chang; Shi, Ting-Ting; Lu, Jing; Cao, Xi; Yang, Fang-Yuan; Feng, Jian-Ping; Chen, Chen
- Abstract
<bold>Objective: </bold>The predictive value of microalbuminuria (MAU) for kidney damage is limited in type 2 diabetes (T2D). We studied whether a urine proteome specific for sight-threatening proliferative diabetic retinopathy (PDR) is an indicator to predict chronic renal insufficiency (CRI) in patients with T2D.<bold>Research Design and Methods: </bold>A shotgun urine proteomic analysis was performed in patients with MAU and PDR (case subjects) and in patients with MAU and a duration of T2D for >10 years but without any degree of retinopathy (control subjects). In the cohort study, 210 patients with T2D with an estimated glomerular filtration rate (eGFR) ≥80 mL/min/1.73 m2 were followed for a median of 5.3 years. Urine proteins specific for PDR were used for predicting CRI (eGFR <60 mL/min/1.73 m2).<bold>Results: </bold>The top two urine proteins with the highest difference in ratio of case subjects to control subjects were haptoglobin (8.7 times; P < 0.0001) and α-2-macroglobulin (5.7 times; P < 0.0001). In the cohort study, patients with baseline urinary haptoglobin ≥20 ng/min (haptoglobinuria) had a higher incidence of CRI than those without (hazard ratio [95% CI] 3.27 [1.41-7.58]; P = 0.006). The overall CRI rate was 3.2% for patients without haptoglobinuria or MAU, 9.5% for those with MAU, and 13.3% for those with haptoglobinuria. The highest rate for CRI (22.4%) was in patients with both MAU and haptoglobinuria (P < 0.001).<bold>Conclusions: </bold>Urine haptoglobin, which is specific for PDR, is a novel biomarker and complement to urine albumin for predicting kidney damage in patients with T2D.
- Subjects
CHRONIC kidney failure; PEOPLE with diabetes; DIABETIC retinopathy; COHORT analysis; ALBUMINURIA; CHRONIC kidney failure complications; TYPE 2 diabetes complications; BLOOD proteins; GLOBULINS; GLOMERULAR filtration rate; LONGITUDINAL method; TYPE 2 diabetes; PROTEOMICS; DISEASE incidence; CASE-control method; DISEASE complications
- Publication
Diabetes Care, 2017, Vol 40, Issue 2, p253
- ISSN
0149-5992
- Publication type
journal article
- DOI
10.2337/dc16-1529