title: Increased urinary orosomucoid excretion is not related to impaired renal function in patients with type 2 diabetes.
abstract: OBJECTIVE
  Increased urinary orosomucoid excretion rate (UOER) independently predicted cardiovascular mortality in patients with type 2 diabetes at 5-years of follow-up. To further explore UOER in relation to local renal physiological phenomena, we studied renal glomerular and tubular functions in patients with type 2 diabetes and normal or increased UOER.
  
  
  METHODS
  We performed a cross-sectional study of 40 patients with type 2 diabetes (normal UOER, n=16; increased UOER, n=24) who displayed no signs of cardiovascular disease and 21 healthy control persons. The renal clearance values of [(51)Cr]ethylenediaminetetraacetic acid ([(51)Cr]EDTA), lithium, orosomucoid, albumin, and sodium were measured.
  
  
  RESULTS
  Patients with type 2 diabetes had normal glomerular filtration rate (GFR) measured by [(51)Cr]EDTA clearance. The clearance value of orosomucoid was highly increased in patients with increased UOER. The clearance values of albumin were similar in patients with increased UOER and in healthy controls. Investigations of renal tubular function revealed normal and similar levels of lithium clearance and proximal and distal reabsorption of sodium and water. Serum values of orosomucoid were higher in patients with increased UOER than in healthy controls (P<.001), but were still within reference limits, suggesting chronic low-grade inflammation. UOER was associated with increasing values of orosomucoid clearance (P<.0001) independently of serum orosomucoid.
  
  
  CONCLUSIONS
  Patients with type 2 diabetes and increased UOER had normal GFR and showed no signs of renal glomerular or tubular dysfunction. We therefore hypothesize that increased levels of UOER may be caused by local renal production of orosomucoid due to chronic low-grade inflammation.
authors.affiliation: Department of Clinical Biochemistry, Amager Hospital, Copenhagen, Denmark. skovdal@dadlnet.dk
authors.forename: Merete Skovdal
authors.initials: MS
authors.lastname: Christiansen
authors.forename: Eva
authors.initials: E
authors.lastname: Hommel
authors.forename: Lars
authors.initials: L
authors.lastname: Friberg
authors.forename: Jens
authors.initials: J
authors.lastname: Mølvig
authors.forename: Erik
authors.initials: E
authors.lastname: Magid
authors.forename: Bo
authors.initials: B
authors.lastname: Feldt-Rasmussen
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000503:physiopathology* / Q000652:urine; D005260:Female; D006801:Humans; D007249:Inflammation / Q000150:complications; D007668:Kidney / Q000503:physiopathology*; D007677:Kidney Function Tests; D008297:Male; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D009961:Orosomucoid / Q000493:pharmacokinetics / Q000652:urine*; D051437:Renal Insufficiency / Q000150:complications / Q000503:physiopathology
chemical_list: D009961:Orosomucoid