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. 2017 Jan 16:7:40627.
doi: 10.1038/srep40627.

Soluble urokinase receptor (suPAR) predicts microalbuminuria in patients at risk for type 2 diabetes mellitus

Martina Guthoff  1   2   3 , Robert Wagner  1   2   3 , Elko Randrianarisoa  1   2   3 , Erifili Hatziagelaki  4 , Andreas Peter  1   2   3 , Hans-Ulrich Häring  1   2   3 , Andreas Fritsche  1   2   3 , Nils Heyne  1   2   3
Affiliations

Soluble urokinase receptor (suPAR) predicts microalbuminuria in patients at risk for type 2 diabetes mellitus

Martina Guthoff et al. Sci Rep. .

Abstract

Early identification of patients at risk of developing diabetic nephropathy is essential. Elevated serum concentrations of soluble urokinase receptor (suPAR) associate with diabetes mellitus and predict onset and loss of renal function in chronic kidney disease. We hypothesize, that suPAR may be an early risk indicator for diabetic nephropathy, preceding microalbuminuria. The relationship of baseline suPAR and incident microalbuminuria was assessed in a prospective long-term cohort of subjects at increased risk for type 2 diabetes (TULIP, n = 258). Association with albuminuria at later stages of disease was studied in a cross-sectional cohort with manifest type 2 diabetes (ICEPHA, n = 266). A higher baseline suPAR was associated with an increased risk of new-onset microalbuminuria in subjects at risk for type 2 diabetes (hazard ratio 5.3 (95% CI 1.1-25.2, p = 0.03) for the highest vs. lowest suPAR quartile). The proportion of subjects with prediabetes at the end of observation was higher in subjects with new-onset microalbuminuria. suPAR consistently correlated with albuminuria in a separate cohort with manifest type 2 diabetes. Elevated baseline suPAR concentrations independently associate with new-onset microalbuminuria in subjects at increased risk of developing type 2 diabetes. suPAR may hence allow for earlier risk stratification than microalbuminuria.

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Figures

Figure 1
Figure 1. Distribution of suPAR concentrations in cohorts.
Distribution of suPAR concentrations in respective cohorts (TULIP prospective cohort and ICEPHA cross-sectional cohort).
Figure 2
Figure 2. Cumulative hazard of incident microalbuminuria.
Cumulative hazard of incident microalbuminuria in longitudinal follow-up of the TULIP prospective cohort.
Figure 3
Figure 3. Relative hazard of baseline suPAR for incident microalbuminuria.
Non-linear relative hazard function plot (effect estimates from the weighted cox regression model) showing the modeled association between baseline suPAR concentrations and incident microalbuminuria in the TULIP prospective cohort.
See this image and copyright information in PMC

References

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