Publication Date
5-1-2023
Journal
Diabetes Research and Clinical Practice
DOI
10.1016/j.diabres.2023.110671
PMID
37068551
PMCID
PMC10207151
PubMedCentral® Posted Date
5-1-2024
PubMedCentral® Full Text Version
Author MSS
Published Open-Access
yes
Keywords
Humans, Male, Adolescent, Female, Diabetes Mellitus, Type 2, Albuminuria, Pulse Wave Analysis, Glomerular Filtration Rate, Kidney Diseases, Biomarkers, Risk Factors, type 2 diabetes, pediatrics, circulating biomarkers, kidney disease, cardiovascular disease, risk assessment
Abstract
AIMS: Evaluate changes in circulating biomarkers as predictors of kidney disease, and cardiac/vascular dysfunction in participants from the Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY) study.
METHODS: Candidate biomarkers were assessed annually in 507 participants over a mean follow-up of 6.9 ± 2.4 years. Moderate albuminuria was defined as urine albumin-to-creatinine ratio ≥ 30 mg/g and hyperfiltration as eGFR ≥ 135 mL/min/1.73 m
RESULTS: At baseline, 35.7% were male, with a mean age 13.9 years, diabetes duration 7.8 months, and HbA1c 6.0%. Higher concentrations of E-selectin and proinsulin were associated with incident moderate albuminuria and hyperfiltration. Higher concentrations of FGF-23 were associated with lower risk of hyperfiltration and negatively correlated with eGFR. No candidate biomarkers predicted a decline in cardiac or vascular function.
CONCLUSIONS: Circulating biomarkers of endothelial dysfunction and markers of β-cell dysfunction and insulin sensitivity could be used in a more personalized risk assessment of kidney disease in youth-onset type 2 diabetes. However, biomarkers studied have limited value in predicting cardiac dysfunction or vascular stiffness.
Graphical Abstract
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Critical Care Commons, Endocrinology, Diabetes, and Metabolism Commons, Internal Medicine Commons, Medical Sciences Commons, Nephrology Commons, Pediatrics Commons