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Soluble urokinase plasminogen activator receptor levels are elevated and associated with complications in patients with type 1 diabetes
Author(s) -
Theilade S.,
Lyngbæk S.,
Hansen T. W.,
EugenOlsen J.,
Fenger M.,
Rossing P.,
Jeppesen J. L.
Publication year - 2015
Publication title -
journal of internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.625
H-Index - 160
eISSN - 1365-2796
pISSN - 0954-6820
DOI - 10.1111/joim.12269
Subject(s) - medicine , diabetes mellitus , microalbuminuria , albuminuria , endocrinology , type 2 diabetes , cardiology , blood pressure , odds ratio , arterial stiffness , gastroenterology
Objectives Soluble urokinase plasminogen activator receptor (su PAR ) is a marker of inflammation and endothelial dysfunction. We investigated the associations between su PAR and diabetes, including diabetes duration and complications, in patients with type 1 diabetes. Design, setting and subjects From 2009 to 2011, 667 patients with type 1 diabetes and 51 nondiabetic control subjects were included in a cross‐sectional study at Steno Diabetes Center, Gentofte, Denmark. su PAR levels were measured with an enzyme‐linked immunosorbent assay. Main outcome measures The investigated diabetic complications were cardiovascular disease ( CVD : previous myocardial infarction, revascularisation, peripheral arterial disease and stroke), autonomic dysfunction (heart rate variability during deep breathing <11 beats min −1 ), albuminuria [urinary albumin excretion rate ( UAER ) ≥30 mg/24 h] or a high degree of arterial stiffness (pulse wave velocity ≥10 m s −1 ). Analyses were adjusted for gender, age, systolic blood pressure, estimated glomerular filtration rate, UAER , glycated haemoglobin (HbA 1c ), total cholesterol, body mass index, C‐reactive protein, antihypertensive treatment and smoking. Results Soluble urokinase plasminogen activator receptor levels were lower in control subjects versus all patients, in control subjects versus normoalbuminuric patients ( UAER <30 mg/24 h), in normoalbuminuric patients with short (<10 years) versus long diabetes duration and were increased with degree of albuminuria (adjusted P < 0.001 for all). Furthermore, su PAR levels were higher in patients with versus without CVD ( n = 144; 21.3%), autonomic dysfunction ( n = 369; 59.2%), albuminuria ( n = 357; 53.1%) and a high degree of arterial stiffness ( n = 298; 47.2%) (adjusted P ≤ 0.024). The adjusted odds ratio (95% confidence interval) values per 1 ln unit increase in su PAR were as follows: 2.5 (1.1–5.7) for CVD : 2.7 (1.2–6.2) for autonomic dysfunction; 3.8 (1.3–10.9) for albuminuria and 2.5 (1.1–6.1) for a high degree of arterial stiffness ( P ≤ 0.039). Conclusion The su PAR level is higher in patients with type 1 diabetes and is associated with diabetes duration and complications independent of other risk factors. su PAR is a potential novel risk marker for the management of diabetes.