Research
Print page Print page
Switch language
The Capital Region of Denmark - a part of Copenhagen University Hospital
Published

Urinary peptidome and diabetic retinopathy in the DIRECT-Protect 1 and 2 trials

Research output: Contribution to journalJournal articlepeer-review

DOI

  1. Diagnostic and prognostic value of the electrocardiogram in stable outpatients with type 2 diabetes

    Research output: Contribution to journalJournal articlepeer-review

  2. Report from the CVOT Summit 2021: new cardiovascular, renal, and glycemic outcomes

    Research output: Contribution to journalComment/debatepeer-review

  • DIRECT Programme Study Group
View graph of relations

BACKGROUND: Given the association of diabetic retinopathy (DR) and kidney disease, we investigated the urinary peptidome to presence and deterioration of DR in a post hoc analysis of trials investigating the effect of candesartan on progression of DR in type 1 and type 2 diabetes, respectively.

METHODS: Baseline urinary peptidomic analysis was performed on a random selection of 783 and 792 subjects in two randomized controlled trials, DIRECT-Protect 1 and 2, respectively. End points were two-step (RET2) and three-step (RET3) change in Early Treatment of Diabetic Retinopathy Study protocol (ETDRS) defined level. Peptide levels were correlated to baseline EDTRS level in a discovery set of 2/3 of the participants from DIRECT-Protect 1. The identified peptides were then validated cross-sectionally in the remaining 1/3 from DIRECT-Protect 1. Thereafter, peptides identified in the discovery set were assessed in the entire DIRECT-Protect 1 and 2 cohorts and significant peptides were tested longitudinally.

RESULTS: Follow-up ranged 4.0-4.7 years. 24 peptides were associated with baseline DR in the discovery set. COL3A1 (seq: NTG~) and COL4A1 (seq: DGA~) were associated with baseline DR in the validation set (Rho: -.223, p < 0.001 and Rho: -.141, p = 0.024). Neither was significantly associated with end points. Assessing the 24 identified peptides in the entire cohorts, several collagen peptides were associated with baseline DR and end points; however, there was no overlap across diabetes types.

CONCLUSIONS: We identified several urinary peptides (mainly collagen) associated with the presence of DR, however they could not be conclusively associated with worsening of DR.

Original languageEnglish
Article numbere14634
JournalDiabetic Medicine
Volume38
Issue number9
Pages (from-to)e14634
ISSN1464-5491
DOIs
Publication statusPublished - Sep 2021

    Research areas

  • clinical diabetes, clinical trials, nephropathy, peptidomics, retinopathy

ID: 66900669