Urinary PGDS levels are associated with vascular injury in type 2 diabetes patients.
BACKGROUND
The presence of metabolic syndrome has been shown to be predictors of cardiovascular morbidity and mortality in patients with type 2 diabetes. In a cross-sectional clinical study, we investigated the association of metabolic syndrome with asymptomatic lacunar strokes and cardiovascular disease (CVD) and we compared its significance with urinary protein markers.


METHODS
We studied Japanese type 2 diabetes patients (n=233, men=124, women=109). The diagnosis of metabolic syndrome was made according to WHO and International Diabetes Federation (IDF) criteria. Cardiovascular events were recorded and asymptomatic lacunar lesions were evaluated with magnetic resonance imaging (MRI). We also measured urinary levels of albumin, type IV collagen, beta2-microglobulin (beta2MG), N-acetyl-beta-d-glucosaminidase (NAG) and lipocalin-type prostaglandin D synthase (PGDS).


RESULTS
The prevalence of metabolic syndrome is 31.3% (IDF) and 52% (WHO) in 233 patients and microalbuminuria was present in 62 subjects (26.6%). Metabolic syndrome (WHO) significantly associated with asymptomatic lacunar lesions (p=0.035, OR=2.854, CI 1.075-7.579), while metabolic syndrome (IDF) or urinary markers failed to associate with presence of asymptomatic lacunar lesions. The presence of metabolic syndrome or microalbuminuria did not show significant association with CVD; however, the elevation of beta2MG, NAG and PGDS showed significant association with CVD. By a logistic regression analysis using urinary proteins as independent variables, the presence of higher PGDS excretion independently associated with history of CVD (p=0.025, OR=3.847, CI 1.180-12.545).


CONCLUSIONS
In type 2 diabetes patients, the elevation of urinary PGDS secretion closely associated with cardiovascular events and may be a supplemental or additional marker to the criteria of metabolic syndrome.
Yoshikawa
Ritsuko
R
Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Okayama, Japan.
Wada
Jun
J
Seiki
Kousuke
K
Matsuoka
Takashi
T
Miyamoto
Satoshi
S
Takahashi
Kenji
K
Ota
Sachiko
S
Taniai
Kazuhi
K
Hida
Kazuyuki
K
Yamakado
Minoru
M
Shikata
Kenichi
K
Uehara
Yoshio
Y
Urade
Yoshihiro
Y
Makino
Hirofumi
H
D000419:Albuminuria / Q000652:urine; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000473:pathology / Q000652:urine*; D002539:Cerebral Arterial Diseases / Q000652:urine; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000473:pathology / Q000652:urine*; D005260:Female; D006801:Humans; D019746:Intramolecular Oxidoreductases / Q000652:urine*; D054834:Lipocalins; D008297:Male; D024821:Metabolic Syndrome / Q000209:etiology* / Q000652:urine*; D008875:Middle Aged
D054834:Lipocalins; D019746:Intramolecular Oxidoreductases; C022466:prostaglandin R2 D-isomerase