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Published online April 4, 2008
Diabetes 57:1966-1970, 2008
DOI: 10.2337/db08-0009
© 2008 by the American Diabetes Association
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Brief Report

Serum Heat Shock Protein 27 and Diabetes Complications in the EURODIAB Prospective Complications Study

A Novel Circulating Marker for Diabetic Neuropathy

Gabriella Gruden1, Graziella Bruno1, Nish Chaturvedi2, Davina Burt1, Casper Schalkwijk3, Silvia Pinach1, Coen D. Stehouwer3, Daniel R. Witte4, John H. Fuller4, Paolo Cavallo Perin1, and the EURODIAB Prospective Complications Study Group

1 Department of Internal Medicine, University of Turin, Turin, Italy
2 National Heart and Lung Institute, Imperial College, London, U.K
3 Department of Internal Medicine, University Hospital Maastricht, Maastricht, the Netherlands
4 Department of Epidemiology and Public-Health, Royal Free and University College London, Medical School, London, U.K

Corresponding author: Gabriella Gruden, gabriella.gruden{at}unito.it

OBJECTIVE—Heat shock protein 27 (HSP27) is a member of the small heat shock protein family of proteins. HSP27 expression is enhanced in target tissues of diabetic microvascular complications, and changes in circulating serum HSP27 levels (sHSP27) have been reported in patients with macrovascular disease. We investigated whether sHSP27 levels were associated with micro- and macrovascular complications in type 1 diabetic patients.

RESEARCH DESIGN AND METHODS—A cross-sectional, nested, case-control study from the EURODIAB Prospective Complications Study of 531 type 1 diabetic patients was performed. Case subjects (n = 363) were defined as those with one or more complications of diabetes; control subjects (n = 168) were defined as those with no evidence of any complication. We measured sHSP27 levels and investigated their associations with diabetes complications.

RESULTS—Mean sHSP27 levels were significantly higher in case subjects with distal symmetrical polyneuropathy (DSP) than in control subjects, even after adjustment for age and albumin excretion rate (AER) (785.9 vs. 574.7 pg/ml, P = 0.03). In logistic regression analysis, sHSP27 levels in the upper quartile were associated with a twofold increased odds ratio (OR) of DSP, independently of conventional risk factors, markers of inflammation, and AER (OR 2.41 [95% CI 1.11–5.24]).

CONCLUSIONS—In this large cohort of type 1 diabetic subjects, we found an independent association between sHSP27 and DSP. This suggests that sHSP27 levels may be a novel marker for diabetic neuropathy.


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Copyright © 2008 by the American Diabetes Association.