title: Soluble urokinase receptor (suPAR) predicts microalbuminuria in patients at risk for type 2 diabetes mellitus.
abstract: Early identification of patients at risk of developing diabetic nephropathy is essential. Elevated serum concentrations of soluble urokinase receptor (suPAR) associate with diabetes mellitus and predict onset and loss of renal function in chronic kidney disease. We hypothesize, that suPAR may be an early risk indicator for diabetic nephropathy, preceding microalbuminuria. The relationship of baseline suPAR and incident microalbuminuria was assessed in a prospective long-term cohort of subjects at increased risk for type 2 diabetes (TULIP, n = 258). Association with albuminuria at later stages of disease was studied in a cross-sectional cohort with manifest type 2 diabetes (ICEPHA, n = 266). A higher baseline suPAR was associated with an increased risk of new-onset microalbuminuria in subjects at risk for type 2 diabetes (hazard ratio 5.3 (95% CI 1.1-25.2, p = 0.03) for the highest vs. lowest suPAR quartile). The proportion of subjects with prediabetes at the end of observation was higher in subjects with new-onset microalbuminuria. suPAR consistently correlated with albuminuria in a separate cohort with manifest type 2 diabetes. Elevated baseline suPAR concentrations independently associate with new-onset microalbuminuria in subjects at increased risk of developing type 2 diabetes. suPAR may hence allow for earlier risk stratification than microalbuminuria.
authors.affiliation: Dept. of Endocrinology and Diabetology, Angiology, Nephrology and Clinical Chemistry, University of Tübingen, Otfried-Müller-Str. 10, 72076 Tübingen, Germany.|Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Otfried-Müller-Str. 47, 72076, Tübingen, Germany.|German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany.
authors.forename: Martina
authors.initials: M
authors.lastname: Guthoff
authors.affiliation: Dept. of Endocrinology and Diabetology, Angiology, Nephrology and Clinical Chemistry, University of Tübingen, Otfried-Müller-Str. 10, 72076 Tübingen, Germany.|Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Otfried-Müller-Str. 47, 72076, Tübingen, Germany.|German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany.
authors.forename: Robert
authors.initials: R
authors.lastname: Wagner
authors.affiliation: Dept. of Endocrinology and Diabetology, Angiology, Nephrology and Clinical Chemistry, University of Tübingen, Otfried-Müller-Str. 10, 72076 Tübingen, Germany.|Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Otfried-Müller-Str. 47, 72076, Tübingen, Germany.|German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany.
authors.forename: Elko
authors.initials: E
authors.lastname: Randrianarisoa
authors.affiliation: Dept. of Internal Medicine II, Research Institute and Diabetes Center, Athens University, Attikon University General Hospital, Athens, Greece.
authors.forename: Erifili
authors.initials: E
authors.lastname: Hatziagelaki
authors.affiliation: Dept. of Endocrinology and Diabetology, Angiology, Nephrology and Clinical Chemistry, University of Tübingen, Otfried-Müller-Str. 10, 72076 Tübingen, Germany.|Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Otfried-Müller-Str. 47, 72076, Tübingen, Germany.|German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Peter
authors.affiliation: Dept. of Endocrinology and Diabetology, Angiology, Nephrology and Clinical Chemistry, University of Tübingen, Otfried-Müller-Str. 10, 72076 Tübingen, Germany.|Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Otfried-Müller-Str. 47, 72076, Tübingen, Germany.|German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany.
authors.forename: Hans-Ulrich
authors.initials: HU
authors.lastname: Häring
authors.affiliation: Dept. of Endocrinology and Diabetology, Angiology, Nephrology and Clinical Chemistry, University of Tübingen, Otfried-Müller-Str. 10, 72076 Tübingen, Germany.|Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Otfried-Müller-Str. 47, 72076, Tübingen, Germany.|German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Fritsche
authors.affiliation: Dept. of Endocrinology and Diabetology, Angiology, Nephrology and Clinical Chemistry, University of Tübingen, Otfried-Müller-Str. 10, 72076 Tübingen, Germany.|Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Otfried-Müller-Str. 47, 72076, Tübingen, Germany.|German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany.
authors.forename: Nils
authors.initials: N
authors.lastname: Heyne
mesh_terms: D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000097:blood* / Q000150:complications*; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications*; D023381:Endpoint Determination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D055293:Receptors, Urokinase Plasminogen Activator / Q000097:blood*; D012307:Risk Factors; D012995:Solubility
chemical_list: D055293:Receptors, Urokinase Plasminogen Activator