Albuminuria and hypertension are independently associated with circulating antipericyte autoantibodies in type 2 diabetic patients.
OBJECTIVE
To determine whether albuminuria, hypertension, or HbA 1c are independently associated with antipericyte autoantibodies (APAAs) in type 2 diabetes mellitus.


METHODS
Two hundred ninety-nine subjects with different degrees of retinopathy according to the Early Treatment Diabetic Retinopathy Study Scale participated in this study. Albuminuria was defined as an albumin/creatinine ratio above the normal cutoff limit, that is, 2.0 g/mol for men and 2.8 g/mol for women. Hypertension was defined as a diastolic blood pressure more than 90 mm Hg, a systolic blood pressure more than 140 mm Hg, or pharmacological antihypertensive treatment. Serum APAAs were detected by immunofluorescence on tissue-cultured bovine retinal pericytes. Association analysis was performed using univariate and multivariate statistical tools.


RESULTS
In type 2 diabetes, APAAs were independently associated with albuminuria (OR = 0.56; P < .04), hypertension (OR = 2.21; P < .01), as well as with proliferative retinopathy (OR = 0.39; P < .01).


CONCLUSIONS
The increased prevalence of APAA in patients with hypertension may suggest that these antibodies are related to tissue damage and repair and that the decline in frequency with albuminuria may serve as a marker for more advanced angiopathy. Future longitudinal studies are needed to determine whether the frequency of APAA is associated with the progression of angiopathy, and to determine the biological activity and antigens recognized by the antibody.
Nayak
Ramesh C
RC
Department of Ophthalmology, Tufts University School of Medicine, Tufts Center for Vision Research and New England Eye Center, Boston, MA 02111, USA. rnayak@eyes.arizona.edu
Agardh
Elizabet
E
Kwok
Michael G K
MG
Farthing-Nayak
Pamela J
PJ
Lynch
Kristian
K
Agardh
Carl-David
CD
D000368:Aged; D000419:Albuminuria / Q000150:complications / Q000276:immunology*; D001323:Autoantibodies / Q000032:analysis*; D002851:Chromatography, High Pressure Liquid; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000276:immunology*; D003930:Diabetic Retinopathy / Q000276:immunology; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D020286:Pericytes / Q000276:immunology*; D011237:Predictive Value of Tests
D001323:Autoantibodies; D006442:Glycated Hemoglobin