title: Proteinuria predicts 10-year cancer-related mortality in patients with type 2 diabetes.
abstract: BACKGROUND
  We conducted a cohort study to determine if proteinuria predicts cancer-related mortality in type 2 diabetic subjects.
  
  
  METHODS
  Between July 1996 and June 2003, we enrolled 646 type 2 diabetic subjects. Participants were followed-up until December 31, 2008. The vital status was ascertained by linking records with computerized death certificates in Taiwan.
  
  
  RESULTS
  During a median follow-up of 10.4 years, 158 subjects had died, including 59 from cancers. Subjects with proteinuria had a hazard ratio (HR) of 2.77 (95% CI 1.82-4.21) for all-cause mortality and 1.99 (95% CI 1.00-3.94) for cancer-related mortality after adjustment for demographic factors and medical conditions. Specifically, proteinuria showed a trend of increased colon cancer death. The presence of proteinuria significantly improved the predictive ability of cancer-related mortality (increase in concordance statistics or area under the ROC curve=0.03). Patients with both proteinuria and estimated glomerular filtration rate <60 ml/min per 1.73 m² showed higher HR for all-cause mortality than patients with proteinuria only (adjusted HRs (95% CI), 4.01 (2.42-6.67) vs. 2.69 (1.51-4.79), both p<0.01).
  
  
  CONCLUSIONS
  Proteinuria can predict 10-year all-cause and cancer-related mortalities independently in type 2 diabetic subjects, over and above the established risk factors associated with type 2 diabetes.
authors: Public Health Center of Longci District, Tainan, Taiwan.
authors: Tse-Ya
authors: TY
authors: Yu
authors: Hung-Yuan
authors: HY
authors: Li
authors: Yi-Der
authors: YD
authors: Jiang
authors: Tien-Jyun
authors: TJ
authors: Chang
authors: Jung-Nan
authors: JN
authors: Wei
authors: Lee-Ming
authors: LM
authors: Chuang
mesh_terms: D000368:Aged; D015331:Cohort Studies; D003110:Colonic Neoplasms / Q000150:complications / Q000401:mortality / Q000503:physiopathology / Q000652:urine; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000453:epidemiology; D003928:Diabetic Nephropathies / Q000150:complications* / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009369:Neoplasms / Q000150:complications* / Q000401:mortality / Q000503:physiopathology / Q000652:urine; D011446:Prospective Studies; D012372:ROC Curve; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000453:epidemiology; D012307:Risk Factors; D016019:Survival Analysis; D013624:Taiwan / Q000453:epidemiology