Urine π-Glutathion S-transferase but not Tamm-Horsfall protein correlates with Carotid artery intima media thickness in childhood type1 diabetesReportar como inadecuado




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BMC Cardiovascular Disorders

, 14:39

Hypertension and Cardiovascular Risk

Abstract

BackgroundRenal disease remains a serious threat in patients with insulin-dependent type1 diabetes. Hence its detection early in the life of patients with type1 diabetes is crucial. Several lines of evidence suggest similar mechanisms for the development of both renal and arterial disease. We sought to investigate in young patients with type1 diabetes whether π-Glutathione S-transferase to creatinine π-GST:crea and Tamm-Horsfall protein to creatinine THP:crea ratios, markers of distal tubular renal function, relate to subclinical markers of arterial disease, which appear to onset early and develop rapidly in type1 diabetes.

MethodsSeventy-one children and adolescents median age and diabetes duration 14 and 6 years, respectively with type1 diabetes for at least 6 months were assessed for timed urine levels of π-GST, THP, HbA1c, albumin, and plasma C-reactive protein CRP. Carotid artery intima-media thickness IMT, brachial artery flow-mediated dilatation FMD, and cutaneous microvascular function were assessed by high-resolution ultrasound and laser Doppler, respectively.

ResultsTwo patients had microalbuminuria > 20 μg-min, and were therefore removed from the study population. π-GST:crea ratio and THP:crea showed no relationship to the demographic, diabetes, or inflammatory indices. Lower π-GST:crea ratio was associated with greater IMT p = 0.01, r = −0.29, particularly in female patients p = 0.004, r = −0.49. The association of π-GST:crea ratio with IMT was stronger in patients with passive smoke exposure p = 0.002, r = −0.43. Among post-pubertal patients, lower π-GST:crea ratio was also associated with lower microvascular response to Ach acetylcholine; p = 0.03, r = 0.49.

ConclusionsIn young patients with type1 diabetes, proximal tubular dysfunction as suggested by lower levels of π-GST:crea ratio seems to be paralleled by changes in arterial structure and microvascular function.

Keywordsπ-GST Vascular endothelial function Intima media thickness Type1 diabetes Electronic supplementary materialThe online version of this article doi:10.1186-1471-2261-14-39 contains supplementary material, which is available to authorized users.

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Autor: Peter Holmquist - Petru Liuba

Fuente: https://link.springer.com/article/10.1186/1471-2261-14-39







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