Lipid and inflammatory biomarkers and kidney function decline in type 2 diabetes.
OBJECTIVE
Potentially modifiable biomarkers may influence the decline in estimated GFR (eGFR), but few data are currently available in type 2 diabetic adults.


METHODS
We studied 516 women with type 2 diabetes in the Nurses' Health Study with data on lipid and inflammatory biomarkers from plasma collected in 1989 and plasma creatinine in samples collected in 1989 and 2000. An estimated GFR decline of >or=25% over 11 years was the outcome of interest.


RESULTS
Comparing the highest with the lowest quartile, soluble tumour necrosis factor receptor 2 (sTNFR-2) was independently associated with an eGFR decline of >or=25% (multivariate OR 5.81; 95% CI 2.90-11.65); this association was stronger in obese women (OR 16.76; 95% CI 4.69-59.90 for BMI >or=30 kg/m(2); OR 2.78, 95% CI 1.12-6.89 for BMI <30 kg/m(2); p for interaction = 0.02). No lipids (total cholesterol, LDL-cholesterol, HDL-cholesterol, non-HDL-cholesterol, triacylglycerols, lipoprotein(a), or apolipoprotein B) or other markers of inflammation (C-reactive protein, fibrinogen, E-selectin, intracellular cell adhesion molecule 1, leptin or adiponectin) were significantly associated with eGFR decline after multivariable adjustment.


CONCLUSIONS
Elevated sTNFR-2 levels may be an important and potentially modifiable risk factor for eGFR decline in type 2 diabetes, especially in those with a BMI of >or=30 kg/m(2).
Lin
J
J
Renal Division, MRB-4, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA. jlin11@partners.org
Hu
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Mantzoros
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Curhan
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D000328:Adult; D015415:Biomarkers / Q000097:blood*; D001794:Blood Pressure; D015992:Body Mass Index; D002114:Calcinosis / Q000097:blood; D002648:Child; D003331:Coronary Vessels / Q000473:pathology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D003925:Diabetic Angiopathies / Q000097:blood; D003928:Diabetic Nephropathies / Q000097:blood; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007249:Inflammation / Q000097:blood*; D007677:Kidney Function Tests; D008055:Lipids / Q000097:blood*; D008297:Male; D015337:Multicenter Studies as Topic; D011237:Predictive Value of Tests; D013997:Time Factors; D049629:Waist-Hip Ratio
D015415:Biomarkers; D006442:Glycated Hemoglobin; D008055:Lipids