title: Urinary adiponectin excretion: a novel marker for vascular damage in type 2 diabetes.
abstract: OBJECTIVE
  Markers reliably identifying vascular damage and risk in diabetic patients are rare, and reports on associations of serum adiponectin with macrovascular disease have been inconsistent. In contrast to existing data on serum adiponectin, this study assesses whether urinary adiponectin excretion might represent a more consistent vascular damage marker in type 2 diabetes.
  
  
  METHODS
  Adiponectin distribution in human kidney biopsies was assessed by immunohistochemistry, and urinary adiponectin isoforms were characterized by Western blot analysis. Total urinary adiponectin excretion rate was measured in 156 patients with type 2 diabetes who had a history of diabetic nephropathy and 40 healthy control subjects using enzyme-linked immunosorbent assay. Atherosclerotic burden was assessed by common carotid artery intima-media-thickness (IMT).
  
  
  RESULTS
  A homogenous staining of adiponectin was found on the endothelial surface of glomerular capillaries and intrarenal arterioles in nondiabetic kidneys, whereas staining was decreased in diabetic nephropathy. Low-molecular adiponectin isoforms ( approximately 30-70 kDa) were detected in urine by Western blot analysis. Urinary adiponectin was significantly increased in type 2 diabetes (7.68 +/- 14.26 vs. control subjects: 2.91 +/- 3.85 microg/g creatinine, P = 0.008). Among type 2 diabetic patients, adiponectinuria was associated with IMT (r = 0.479, P < 0.001) and proved to be a powerful independent predictor of IMT (beta = 0.360, P < 0.001) in multivariable regression analyses. In a risk prediction model including variables of the UK Prospective Diabetes Study coronary heart disease risk engine urinary adiponectin, but not the albumin excretion rate, added significant value for the prediction of increased IMT (P = 0.007).
  
  
  CONCLUSIONS
  Quantification of urinary adiponectin excretion appears to be an independent indicator of vascular damage potentially identifying an increased risk for vascular events.
authors.affiliation: Department of Nephrology, Technische Universitat Muenchen, Munich, Germany. maximilian.eynatten@lrz.tum.de
authors.forename: Maximilian
authors.initials: M
authors.lastname: von Eynatten
authors.forename: Dan
authors.initials: D
authors.lastname: Liu
authors.forename: Cornelia
authors.initials: C
authors.lastname: Hock
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Oikonomou
authors.forename: Marcus
authors.initials: M
authors.lastname: Baumann
authors.forename: Bruno
authors.initials: B
authors.lastname: Allolio
authors.forename: Grigorios
authors.initials: G
authors.lastname: Korosoglou
authors.forename: Michael
authors.initials: M
authors.lastname: Morcos
authors.forename: Valentina
authors.initials: V
authors.lastname: Campean
authors.forename: Kerstin
authors.initials: K
authors.lastname: Amann
authors.forename: Jens
authors.initials: J
authors.lastname: Lutz
authors.forename: Uwe
authors.initials: U
authors.lastname: Heemann
authors.forename: Peter P
authors.initials: PP
authors.lastname: Nawroth
authors.forename: Angelika
authors.initials: A
authors.lastname: Bierhaus
authors.forename: Per M
authors.initials: PM
authors.lastname: Humpert
mesh_terms: D052242:Adiponectin / Q000652:urine; D000368:Aged; D015415:Biomarkers / Q000652:urine*; D001706:Biopsy; D015153:Blotting, Western; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000652:urine; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000652:urine*; D003925:Diabetic Angiopathies / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000652:urine*; D003928:Diabetic Nephropathies / Q000453:epidemiology / Q000473:pathology / Q000652:urine; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007668:Kidney / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012307:Risk Factors; D014463:Ultrasonography
chemical_list: C499918:ADIPOQ protein, human; D052242:Adiponectin; D015415:Biomarkers