Cardiovascular risk and renal injury profile in subjects with type 2 diabetes and non-albuminuric diabetic kidney disease
© 2023. The Author(s)..
BACKGROUND: In the last years, the classical pattern of diabetic kidney disease (DKD) has been partially overcome, because of the uncovering of a new DKD phenotype with significant renal dysfunction without presence of albuminuria: the non-albuminuric DKD (NA-DKD). To date, the cardiovascular risk associated with this phenotype is still debated. We investigated the cardiovascular risk and renal injury profile of NA-DKD subjects in comparison with other DKD phenotypes.
METHODS: Pulse wave velocity (PWV), intima-media thickness, presence of carotid atherosclerotic plaque, renal resistive index (RRI), and a panel of urinary biomarkers of kidney injury were evaluated in 160 subjects with type 2 diabetes, stratified according to estimated glomerular filtration rate (eGFR) and urinary albumin to creatinine ratio (UACR) into four groups: controls (UACR < 30 mg/g and eGFR ≥ 60 mL/min/1.73 m2), A-DKD (Albuminuric-DKD, UACR ≥ 30 mg/g and eGFR ≥ 60 mL/min/1.73 m2), NA-DKD (UACR < 30 mg/g and eGFR < 60 mL/min/1.73 m2), AL-DKD (Albuminuric and Low eGFR-DKD; UACR ≥ 30 mg/g and eGFR < 60 mL/min/1.73 m2).
RESULTS: Subjects with NA-DKD showed a higher PWV (11.83 ± 3.74 m/s vs. 10.24 ± 2.67 m/s, P = 0.045), RRI (0.76 ± 0.11 vs. 0.71 ± 0.09, P = 0.04), and prevalence of carotid atherosclerotic plaque (59% vs. 31%, P = 0.009) compared with controls. These characteristics were similar to those of subjects with AL-DKD, whereas the profile of A-DKD subjects was closer to controls. After multiple regression analyses, we found that RRI, that is in turn influenced by eGFR (β = - 0.01, P = 0.01), was one of the major determinants of PWV (β = 9.4, P = 0.02). Urinary TreFoil Factor 3, a marker of tubular damage, was higher in NA-DKD subjects vs. controls (1533.14 ± 878.31 ng/mL vs. 1253.84 ± 682.17 ng/mL, P = 0.047). Furthermore, after multiple regression analyses, we found that urinary osteopontin was independently associated with PWV (β = 2.6, P = 0.049) and RRI (β = 0.09, P = 0.006).
CONCLUSIONS: Our data showed a worse cardiovascular and renal injury profile in NA-DKD subjects. This finding emphasizes the central role of eGFR in the definition of cardiovascular risk profile of diabetic subjects together with albuminuria.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:22 |
|---|---|
| Enthalten in: |
Cardiovascular diabetology - 22(2023), 1 vom: 13. Dez., Seite 344 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Di Marco, Maurizio [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Arterial Stiffness |
|---|
| Anmerkungen: |
Date Completed 16.12.2023 Date Revised 13.03.2024 published: Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1186/s12933-023-02065-2 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM365839949 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM365839949 | ||
| 003 | DE-627 | ||
| 005 | 20240314234735.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1186/s12933-023-02065-2 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1328.xml |
| 035 | |a (DE-627)NLM365839949 | ||
| 035 | |a (NLM)38093293 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Di Marco, Maurizio |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Cardiovascular risk and renal injury profile in subjects with type 2 diabetes and non-albuminuric diabetic kidney disease |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 16.12.2023 | ||
| 500 | |a Date Revised 13.03.2024 | ||
| 500 | |a published: Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023. The Author(s). | ||
| 520 | |a BACKGROUND: In the last years, the classical pattern of diabetic kidney disease (DKD) has been partially overcome, because of the uncovering of a new DKD phenotype with significant renal dysfunction without presence of albuminuria: the non-albuminuric DKD (NA-DKD). To date, the cardiovascular risk associated with this phenotype is still debated. We investigated the cardiovascular risk and renal injury profile of NA-DKD subjects in comparison with other DKD phenotypes | ||
| 520 | |a METHODS: Pulse wave velocity (PWV), intima-media thickness, presence of carotid atherosclerotic plaque, renal resistive index (RRI), and a panel of urinary biomarkers of kidney injury were evaluated in 160 subjects with type 2 diabetes, stratified according to estimated glomerular filtration rate (eGFR) and urinary albumin to creatinine ratio (UACR) into four groups: controls (UACR < 30 mg/g and eGFR ≥ 60 mL/min/1.73 m2), A-DKD (Albuminuric-DKD, UACR ≥ 30 mg/g and eGFR ≥ 60 mL/min/1.73 m2), NA-DKD (UACR < 30 mg/g and eGFR < 60 mL/min/1.73 m2), AL-DKD (Albuminuric and Low eGFR-DKD; UACR ≥ 30 mg/g and eGFR < 60 mL/min/1.73 m2) | ||
| 520 | |a RESULTS: Subjects with NA-DKD showed a higher PWV (11.83 ± 3.74 m/s vs. 10.24 ± 2.67 m/s, P = 0.045), RRI (0.76 ± 0.11 vs. 0.71 ± 0.09, P = 0.04), and prevalence of carotid atherosclerotic plaque (59% vs. 31%, P = 0.009) compared with controls. These characteristics were similar to those of subjects with AL-DKD, whereas the profile of A-DKD subjects was closer to controls. After multiple regression analyses, we found that RRI, that is in turn influenced by eGFR (β = - 0.01, P = 0.01), was one of the major determinants of PWV (β = 9.4, P = 0.02). Urinary TreFoil Factor 3, a marker of tubular damage, was higher in NA-DKD subjects vs. controls (1533.14 ± 878.31 ng/mL vs. 1253.84 ± 682.17 ng/mL, P = 0.047). Furthermore, after multiple regression analyses, we found that urinary osteopontin was independently associated with PWV (β = 2.6, P = 0.049) and RRI (β = 0.09, P = 0.006) | ||
| 520 | |a CONCLUSIONS: Our data showed a worse cardiovascular and renal injury profile in NA-DKD subjects. This finding emphasizes the central role of eGFR in the definition of cardiovascular risk profile of diabetic subjects together with albuminuria | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Arterial Stiffness | |
| 650 | 4 | |a Cardiovascular risk | |
| 650 | 4 | |a Diabetic kidney disease | |
| 650 | 4 | |a Non-albuminuric diabetic kidney disease | |
| 650 | 4 | |a Renal resistive index | |
| 650 | 4 | |a Type 2 diabetes | |
| 650 | 4 | |a Urinary biomarkers | |
| 700 | 1 | |a Scilletta, Sabrina |e verfasserin |4 aut | |
| 700 | 1 | |a Miano, Nicoletta |e verfasserin |4 aut | |
| 700 | 1 | |a Marrano, Nicola |e verfasserin |4 aut | |
| 700 | 1 | |a Natalicchio, Annalisa |e verfasserin |4 aut | |
| 700 | 1 | |a Giorgino, Francesco |e verfasserin |4 aut | |
| 700 | 1 | |a Di Mauro, Stefania |e verfasserin |4 aut | |
| 700 | 1 | |a Filippello, Agnese |e verfasserin |4 aut | |
| 700 | 1 | |a Scamporrino, Alessandra |e verfasserin |4 aut | |
| 700 | 1 | |a Tribulato, Paola |e verfasserin |4 aut | |
| 700 | 1 | |a Bosco, Giosiana |e verfasserin |4 aut | |
| 700 | 1 | |a Di Giacomo Barbagallo, Francesco |e verfasserin |4 aut | |
| 700 | 1 | |a Scicali, Roberto |e verfasserin |4 aut | |
| 700 | 1 | |a Milluzzo, Agostino |e verfasserin |4 aut | |
| 700 | 1 | |a Ballirò, Teresa |e verfasserin |4 aut | |
| 700 | 1 | |a Frittitta, Lucia |e verfasserin |4 aut | |
| 700 | 1 | |a Castellino, Pietro |e verfasserin |4 aut | |
| 700 | 1 | |a Purrello, Francesco |e verfasserin |4 aut | |
| 700 | 1 | |a Piro, Salvatore |e verfasserin |4 aut | |
| 700 | 1 | |a Di Pino, Antonino |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Cardiovascular diabetology |d 2002 |g 22(2023), 1 vom: 13. Dez., Seite 344 |w (DE-627)NLM119878380 |x 1475-2840 |7 nnns |
| 773 | 1 | 8 | |g volume:22 |g year:2023 |g number:1 |g day:13 |g month:12 |g pages:344 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1186/s12933-023-02065-2 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 22 |j 2023 |e 1 |b 13 |c 12 |h 344 | ||