title: Low serum endothelial cell-selective adhesion molecule predicts increase in albuminuria in type 2 diabetes patients.
abstract: OBJECTIVE
  The newly discovered endothelial cell-selective adhesion molecule (ESAM) stabilizes the interendothelial tight junction; it circulates in serum as a soluble fraction. In experimental diabetes, reduced ESAM expression in the kidney is associated with albuminuria. We investigated, for the first time, serum ESAM as a predictor of progression of kidney disease in type 2 diabetes (T2D).
  
  
  METHODS
  T2D non-nephrotic patients with glomerular filtration rate (GFR) > 30 ml/min were included. History, medication and laboratory evaluation were assessed at inclusion and the end of study; ESAM was determined at baseline.
  
  
  RESULTS
  Eighty-eight patients--mean age 63 ± 10.84 years, 49 (55.68 %) males--were prospectively followed up for 20 months. Baseline GFR was 76.37 ± 29.56 ml/min, and urinary albumin/creatinine ratio (UACR) 21.63(7.08-94.52) mg/g; ESAM was 12.85(6.13-19.83) ng/ml. Difference (Δ) in UACR between end of study and baseline was inversely related to serum albumin (r = -0.27, p = 0.017) and ESAM (r = -0.21, p = 0.047); ΔGFR correlated to glycated hemoglobin (r = 0.22, p = 0.05). In multiple regression, introducing variables susceptible to influence progression of kidney disease, ΔUACR was significantly related to log ESAM (p = 0.005) and ΔGFR to glycated hemoglobin (p = 0.016).
  
  
  CONCLUSIONS
  Serum ESAM is a predictor of worsening of albuminuria in T2D patients without advanced kidney disease.
authors.affiliation: University of Medicine and Pharmacy "Iuliu Hatieganu" Cluj Napoca, Dornei 47 street, 400171, Cluj Napoca, Romania.
authors.forename: Ina Maria
authors.initials: IM
authors.lastname: Kacso
authors.forename: Cosmina Ioana
authors.initials: CI
authors.lastname: Bondor
authors.forename: Gabriel
authors.initials: G
authors.lastname: Kacso
mesh_terms: D000368:Aged; D000419:Albuminuria / Q000209:etiology*; D015815:Cell Adhesion Molecules / Q000097:blood*; D003404:Creatinine / Q000652:urine; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications; D003928:Diabetic Nephropathies / Q000097:blood* / Q000209:etiology / Q000503:physiopathology*; D018450:Disease Progression; D005260:Female; D005919:Glomerular Filtration Rate; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012709:Serum Albumin / Q000378:metabolism
chemical_list: D015815:Cell Adhesion Molecules; D003404:Creatinine; D006442:Glycated Hemoglobin; D012709:Serum Albumin; C568779:ESAM protein, human