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Udgivet

Higher Collagen VI Formation Is Associated With All-Cause Mortality in Patients With Type 2 Diabetes and Microalbuminuria

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

  1. Impact of Glucose Level on Micro- and Macrovascular Disease in the General Population: A Mendelian Randomization Study

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Lactation Duration and Long-term Risk for Incident Type 2 Diabetes in Women With a History of Gestational Diabetes Mellitus

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Fatty Liver Among Adolescent Offspring of Women With Type 1 Diabetes (the EPICOM Study)

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

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OBJECTIVE: Type 2 diabetes is a common risk factor for the development of chronic kidney disease (CKD). Enhanced de novo collagen type VI (COL VI) formation has been associated with renal fibrosis and CKD. We investigated the hypothesis that PRO-C6, a product specifically generated during COL VI formation, is prognostic for adverse outcomes in patients with type 2 diabetes and microalbuminuria.

RESEARCH DESIGN AND METHODS: In a prospective, observational study, we measured PRO-C6 in serum (S-PRO-C6) and urine (U-PRO-C6) of 198 patients with type 2 diabetes and microalbuminuria without symptoms of coronary artery disease. Patients were followed for a median of 6.5 years, and end points were a composite of cardiovascular events (n = 38), all-cause mortality (n = 26), and reduction of estimated glomerular filtration rate (eGFR) of >30% (disease progression [n = 42]). Cox models were unadjusted and adjusted for the conventional risk factors sex, age, BMI, systolic blood pressure, LDL cholesterol, smoking, HbA1c, plasma creatinine, and urinary albumin excretion rate.

RESULTS: Doubling of S-PRO-C6 increased hazards for cardiovascular events (hazard ratio 3.06 [95% CI 1.31-7.14]), all-cause mortality (6.91 [2.96-16.11]), and disease progression (4.81 [1.92-12.01]). Addition of S-PRO-C6 to a model containing conventional risk factors improved relative integrated discrimination by 22.5% for cardiovascular events (P = 0.02), 76.8% for all-cause mortality (P = 0.002), and 53.3% for disease progression (P = 0.004). U-PRO-C6 was not significantly associated with any of the outcomes.

CONCLUSIONS: S-PRO-C6 generated during COL VI formation predicts cardiovascular events, all-cause mortality, and disease progression in patients with type 2 diabetes and microalbuminuria.

OriginalsprogEngelsk
TidsskriftDiabetes Care
Vol/bind41
Udgave nummer7
Sider (fra-til)1493-1500
Antal sider7
ISSN1935-5548
DOI
StatusUdgivet - jul. 2018

ID: 53659370