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| Increased urinary albumin excretion, endothelial dysfunction, and chronic low-grade inflammation in type 2 diabetes - Progressive, interrelated, and independently associated with risk of death |
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| Author(s): Stehouwer CDA, Gall MA, Twisk JWR, Knudsen E, Emeis JJ, Parving HH |
| Source: DIABETES Volume: 51 Issue: 4 Pages: 1157-1165 Published: APR 2002 |
| Times Cited: 246 References: 27 |
| Abstract: In 328 type 2 diabetic patients followed for 9.0 years (mean), we investigated whether endothelial dysfunction and chronic inflammation (estimated from plasma markers) can explain the association between (micro)albuminuria and mortality. Of the patients, 113 died. Mortality was increased in patients with baseline microalbuminuria or macroalbuminuria (odds ratios as compared with normoalbuminuria, 1.78 [P < 0.05] and 2.86 [P < 0.01]) and in patients with soluble vascular cell adhesion molecule 1 in the third tertile and C-reactive protein in the second and third tertiles (odds ratios as compared with the first tertile, 2.05 [P < 0.01], and 1.80 [P < 0.05] and 2.92 [P < 0.01]). These associations were mutually independent. The mean yearly change in urinary albumin excretion was 9.4%; in von Willebrand factor, 8.1%; in tissue-type plasminogen activator, 2.8%; in soluble vascular cell adhesion molecule 1, 5.2%; in soluble E-selectin, -2.3%; in C-reactive protein, 3.8%; and in fibrinogen, 2.3%. The longitudinal development of urinary albumin excretion was significantly and independently determined by baseline levels of and the longitudinal development of BMI, systolic blood pressure, serum creatinine, glycated hemoglobin and plasma von Willebrand factor (baseline only), soluble E-selectin (baseline only), tissue-type plasminogen activator, C-reactive protein, and fibrinogen. The longitudinal developments of markers of endothelial function and inflammation were interrelated. In type 2 diabetes, increased urinary albumin excretion, endothelial dysfunction, and chronic inflammation are interrelated processes that develop in parallel, progress with time, and are strongly and independently associated with risk of death. |
| Document Type: Article |
| Language: English |
| Reprint Address: Stehouwer, CDA (reprint author), Free Univ Amsterdam, Med Ctr, Dept Internal Med, De Boelelaan 1117, NL-1081 HV Amsterdam, Netherlands |
Addresses:
1. Free Univ Amsterdam, Med Ctr, Dept Internal Med, NL-1081 HV Amsterdam, Netherlands
2. Free Univ Amsterdam, Med Ctr, Cardiovasc Res Inst, NL-1081 HV Amsterdam, Netherlands
3. Steno Diabet Ctr, DK-2820 Gentofte, Denmark
4. Vrije Univ Amsterdam, Med Ctr, EMGO Inst, Inst Res Extramural Med, Amsterdam, Netherlands
5. TNO Prevent & Hlth, Gaubius Lab, Leiden, Netherlands |
| Publisher: AMER DIABETES ASSOC, 1660 DUKE ST, ALEXANDRIA, VA 22314 USA |
| Subject Category: Endocrinology & Metabolism |
| IDS Number: 537BR |
| ISSN: 0012-1797 |
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| | | | | | | | | Record from Web of Science® | | | | | | | | | |