title: Association between microfibrillar-associated protein 4 (MFAP4) and micro- and macrovascular complications in long-term type 1 diabetes mellitus.
abstract: OBJECTIVE
  To evaluate microfibrillar-associated protein 4 (MFAP4) as a marker of micro- and macrovascular complications in patients with type 1 diabetes.
  
  
  METHODS
  This cross-sectional study included 203 persons with a long duration of type 1 diabetes from a population-based cohort ascertained in the former Funen County, Denmark. Detection of plasma-MFAP4 (pMFAP4) was performed by the AlphaLISA Technique. Diabetic retinopathy (DR) was graded in accordance with the Early Treatment Diabetic Retinopathy Study adaptation of the modified Airlie House classification. A monofilament test was used to test for neuropathy, and nephropathy was evaluated in a single spot urine sample. Data describing macrovascular disease were obtained from the Danish National Patient Register.
  
  
  RESULTS
  Median age and duration of diabetes were 58.7 and 43 years, respectively, and 61% were males. High levels of pMFAP4 were found in participants of old age, in women and in non-smokers (p < 0.05). In a multiple logistic regression model, patients with high levels of pMFAP4 were more likely to have diabetic neuropathy (OR 2.47 for quartile 4 versus quartile 1, 95% CI 1.01-6.03). No association was found between pMFAP4 and proliferative diabetic retinopathy, nephropathy or macrovascular disease.
  
  
  CONCLUSIONS
  No association between pMFAP4 and macrovascular vascular complications was found. However, high levels of pMFAP4 correlated independently with diabetic neuropathy. Further studies on the predictive value of increased circulating MFAP4 in diabetic neuropathy are warranted.
authors.affiliation: Department of Ophthalmology, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense C, Denmark. Soren.leer.blindbaek@rsyd.dk.
authors.forename: S L
authors.identifier: http://orcid.org/0000-0003-0628-684X
authors.initials: SL
authors.lastname: Blindbæk
authors.affiliation: Department of Cancer and Inflammation, Institute of Molecular Medicine, University of Southern Denmark, J.B. Winsløws Vej 21-25, 5000, Odense C, Denmark.
authors.forename: A
authors.initials: A
authors.lastname: Schlosser
authors.affiliation: OPEN, Odense Patient data Exploratory Network, Odense University Hospital, J.B. Winsløws Vej 9 A, 3rd floor, 5000, Odense C, Denmark.|OPEN, Odense Patient data Exploratory Network, Department of Clinical Research, University of Southern Denmark, J.B. Winsløws Vej 9 A, 3rd floor, 5000, Odense C, Denmark.
authors.forename: A
authors.initials: A
authors.lastname: Green
authors.affiliation: Department of Cancer and Inflammation, Institute of Molecular Medicine, University of Southern Denmark, J.B. Winsløws Vej 21-25, 5000, Odense C, Denmark.
authors.forename: U
authors.initials: U
authors.lastname: Holmskov
authors.affiliation: Department of Cancer and Inflammation, Institute of Molecular Medicine, University of Southern Denmark, J.B. Winsløws Vej 21-25, 5000, Odense C, Denmark.
authors.forename: G L
authors.initials: GL
authors.lastname: Sorensen
authors.affiliation: Department of Ophthalmology, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense C, Denmark.
authors.forename: J
authors.initials: J
authors.lastname: Grauslund
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood / Q000150:complications / Q000175:diagnosis; D002352:Carrier Proteins / Q000097:blood*; D003430:Cross-Sectional Studies; D003718:Denmark; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000150:complications* / Q000175:diagnosis; D003925:Diabetic Angiopathies / Q000097:blood* / Q000175:diagnosis; D003929:Diabetic Neuropathies / Q000097:blood / Q000150:complications / Q000175:diagnosis; D003930:Diabetic Retinopathy / Q000097:blood / Q000150:complications / Q000175:diagnosis; D016326:Extracellular Matrix Proteins / Q000097:blood*; D005260:Female; D006023:Glycoproteins / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D002352:Carrier Proteins; D016326:Extracellular Matrix Proteins; D006023:Glycoproteins; C400752:MFAP4 protein, human
keywords: Complications; Microfibrillar-associated protein 4 (MFAP4); Pathophysiology; Type 1 diabetes mellitus