Urinary liver-type fatty acid binding protein is an independent predictor of stroke and mortality in individuals with type 1 diabetes

• Verfasst von: Panduru, Nicolae [VerfasserIn]
• Verfasst von: Bierhaus, Angelika [VerfasserIn]
• Verfasst von: Humpert, Per Magnus [VerfasserIn]
• Titel: Urinary liver-type fatty acid binding protein is an independent predictor of stroke and mortality in individuals with type 1 diabetes
• Verf.angabe: Nicolae M. Panduru, Carol Forsblom, Markku Saraheimo, Lena M. Thorn, Daniel Gordin, Nina Elonen, Valma Harjusalo, Angelika Bierhaus, Per M. Humpert, Per-Henrik Groop, on behalf of the FinnDiane Study Group
• E-Jahr: 2017
• Jahr: 10 June 2017
• Umfang: 9 S.
• Teil: volume:60
• Teil: year:2017
• Teil: number:9
• Teil: pages:1782-1790
• Teil: extent:9
• Fussnoten: Gesehen am 03.09.2018
• Titel Quelle: Enthalten in: Diabetologia
• Ort Quelle: Berlin : Springer, 1965
• Jahr Quelle: 2017
• Band/Heft Quelle: 60(2017), 9, Seite 1782-1790
• ISSN Quelle: 1432-0428
• DOI: doi:10.1007/s00125-017-4328-x
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Cardiovascular disease
• Sach-SW: Diabetic complications
• Sach-SW: Liver-type fatty acid binding protein
• Sach-SW: Mortality
• Sach-SW: Stroke
• Sach-SW: Type 1 diabetes
• Sach-SW: Urinary biomarkers
• Sach-SW: Urinary L-FABP
• K10plus-PPN: 158060546X

Abstract

Aims/hypothesis: In type 1 diabetes, cardiovascular disease (CVD) and diabetic nephropathy progress in parallel, thereby potentiating the risk of premature death during their development. Since urinary liver-type fatty acid binding protein (L-FABP) predicts the progression of diabetic nephropathy, the aim of this study was to investigate whether urinary L-FABP also predicts cardiovascular outcomes and mortality.MethodsWe tested our hypothesis in a Finnish cohort of 2329 individuals with type 1 diabetes and a median follow-up of 14.1 years. The L-FABP to creatinine ratio was determined from baseline urine samples. The predictive value of urinary L-FABP was evaluated using Cox regression models, while its added predictive benefit for cardiovascular outcomes and mortality was evaluated using a panel of statistical indexes.ResultsUrinary L-FABP predicted incident stroke independently of traditional risk factors (HR 1.33 [95% CI 1.20, 1.49]) and after further adjustment for eGFR (HR 1.28 [95% CI 1.14, 1.44]) or AER (HR 1.24 [95% CI 1.06, 1.44]). In addition, it predicted mortality independently of traditional risk factors (HR 1.34 [95% CI 1.24, 1.45]), and after adjustment for eGFR (HR 1.29 [95% CI 1.18, 1.39]) or AER (HR 1.22 [95% CI 1.09, 1.36]). Urinary L-FABP was as good a predictor as eGFR or AER, and improved the AUC for both outcomes on top of traditional risk factors, with no reclassification benefit (integrated discrimination improvement/net reclassification improvement) for stroke or mortality when AER or eGFR were added to traditional risk factors. However, urinary L-FABP was not a predictor of other cardiovascular endpoints (coronary artery disease, peripheral vascular disease and overall CVD events) when adjusted for the AER.Conclusions/interpretationUrinary L-FABP is an independent predictor of stroke and mortality in individuals with type 1 diabetes.