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Abstract: TH-PO936

Systemic Inflammation Precedes New-Onset Microalbuminuria in Diabetes Mellitus Type II: A Post Hoc Analysis of the ROADMAP Study

Session Information

Category: Diabetic Kidney Disease

  • 602 Diabetic Kidney Disease: Clinical

Authors

  • Chatzikyrkou, Christos D., Universitaetsklinikum Magdeburg, Magdeburg, Germany
  • Menne, Jan, Medical School Hannover, Hannover, Germany
  • Brandt, Sabine, University Hospital Magdeburg, Magdeburg, Germany
  • Bernhardt, Anja, Universitätsklinikum Magdeburg , Magdeburg, Germany
  • Mertens, Peter R., Universitätsklinikum Magdeburg , Magdeburg, Germany
  • Haller, Hermann G., Medical School Hannover, Hannover, Germany
  • Scurt, Florian Gunnar, Otto von Guericke University Magdeburg - Medical Faculty, Magdeburg, SH, Germany
Background

The aim of the case-control study was to investigate if serum biomarkers indicative of vascular inflammation and endothelial dysfunction can predict the development of microalbuminuria in patients with diabetes mellitus type II.

Methods

Amongst participants enrolled in the ROADMAP (Randomized Olmesartan And Diabetes MicroAlbuminuria Prevention) and observational follow-up (OFU) studies, a panel of 15 serum biomarkers was quantified from samples obtained at initiation of the study and tested for associations with the development of new-onset microalbuminuria (defined as a urinary albumin to creatinine ratio (UACR) of more than 35 mg/g in women or more than 25 mg/g in men) during follow-up. A case-control study was conducted with inclusion of 172 patients with microalbuminuria and 188 matched controls. Non-parametric inferential, nonlinear regression, mediation and bootstrapping statistical methods were used for the analysis

Results

The median follow-up time was 37 months. At baseline, mean concentrations of CXCL-16, TGF-β1 and angiopoietin-2 were higher in patients with subsequent microalbuminuria. In the multivariate analysis, after adjustment for age, sex, BMI, HbA1c, duration of diabetes, LDL, smoking status, blood pressure, baseline UACR, eGFR, time of follow-up and cardiovascular disease, CXCL-16 (OR 2.60, 95% CI 1.71-3.96), angiopoietin-2 (OR 1.50, 95% CI 1.14-1.98) and TGF-β1 (OR 1.03, 95% CI 1.01-1.04) remained significant predictors of new-onset microalbuminuria (p<0.001). Inclusion of these biomarkers in conventional clinical risk models for prediction of microalbuminuria increased the AUC from 0.638 to 0.760 (p <0.001).

Conclusion

In type II diabetes patients elevated plasma levels of CXCL-16, angiopoietin-2 and TGF-β1 are independently predictive of microalbuminuria. Thus, these serum markers improve renal risk models beyond established clinical risk factors.