title: Urinary type IV collagen is related to left ventricular diastolic function and brain natriuretic peptide in hypertensive patients with prediabetes.
abstract: OBJECTIVE
  Urinary type IV collagen is an early biomarker of diabetic nephropathy. Concomitant prediabetes (the early stage of diabetes) was associated with left ventricular (LV) diastolic dysfunction and increased brain natriuretic peptide (BNP) in hypertensive patients. We hypothesized that urinary type IV collagen may be related to these cardiac dysfunctions.
  
  
  METHODS
  We studied hypertensive patients with early prediabetes (HbA1c <5.7% and fasting glucose >110, n=18), those with prediabetes (HbA1c 5.7-6.4, n=98), and those with diabetes (HbA1c>6.5 or on diabetes medications, n=92). The participants underwent echocardiography to assess left atrial volume/body surface area (BSA) and the ratio of early mitral flow velocity to mitral annular velocity (E/e'). Left ventricular diastolic dysfunction (LVDD) was defined if patients had E/e'≥15, or E/e'=9-14 accompanied by left atrial volume/BSA≥32ml/mm(2). Urinary samples were collected for type IV collagen and albumin, and blood samples were taken for BNP and HbA1c.
  
  
  RESULTS
  Urinary type IV collagen and albumin increased in parallel with the deterioration of glycemic status. In hypertensive patients with prediabetes, subjects with LVDD had higher levels of BNP and urinary type IV collagen than those without LVDD. In contrast, in hypertensive patients with diabetes, subjects with LVDD had higher urinary albumin and BNP than those without LVDD. Urinary type IV collagen correlated positively with BNP in hypertensive patients with prediabetes, whereas it correlated with HbA1c in those with diabetes.
  
  
  CONCLUSIONS
  In hypertensive patients with prediabetes, urinary type IV collagen was associated with LV diastolic dysfunction and BNP.
authors.affiliation: Department of Cardiology, Mitsubishi Nagoya Hospital, Nagoya, Japan. Electronic address: masato2_iida@mhi.co.jp.
authors.forename: Masato
authors.initials: M
authors.lastname: Iida
authors.affiliation: Department of Cardiology, Mitsubishi Nagoya Hospital, Nagoya, Japan.
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Yamamoto
authors.affiliation: Department of Cardiology, Mitsubishi Nagoya Hospital, Nagoya, Japan.
authors.forename: Yuko S
authors.initials: YS
authors.lastname: Ishiguro
authors.affiliation: Department of Cardiology, Mitsubishi Nagoya Hospital, Nagoya, Japan.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Yamazaki
authors.affiliation: Department of Cardiovascular Research, Research Institute of Environmental Medicine, Nagoya University, Nagoya, Japan.
authors.forename: Norihiro
authors.initials: N
authors.lastname: Ueda
authors.affiliation: Department of Cardiovascular Research, Research Institute of Environmental Medicine, Nagoya University, Nagoya, Japan.
authors.forename: Haruo
authors.initials: H
authors.lastname: Honjo
authors.affiliation: Department of Cardiovascular Research, Research Institute of Environmental Medicine, Nagoya University, Nagoya, Japan.
authors.forename: Kaichirou
authors.initials: K
authors.lastname: Kamiya
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000097:blood / Q000150:complications / Q000503:physiopathology; D001786:Blood Glucose / Q000378:metabolism; D024141:Collagen Type IV / Q000652:urine*; D004452:Echocardiography; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000150:complications / Q000503:physiopathology / Q000652:urine; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011236:Prediabetic State / Q000097:blood / Q000150:complications / Q000503:physiopathology / Q000652:urine; D018487:Ventricular Dysfunction, Left / Q000097:blood / Q000503:physiopathology / Q000652:urine; D016277:Ventricular Function, Left / Q000502:physiology*
chemical_list: D001786:Blood Glucose; D024141:Collagen Type IV; D020097:Natriuretic Peptide, Brain
keywords: BNP; Echocardiography; Hypertension; Left ventricular diastolic function; Prediabetes; Urinary type IV collagen