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
- 1Department of Internal Medicine, University of Turin, Turin, Italy
- 2National Heart and Lung Institute, Imperial College, London, U.K
- 3Department of Internal Medicine, University Hospital Maastricht, Maastricht, the Netherlands
- 4Department 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
Abstract
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.
Footnotes
-
Published ahead of print at http://diabetes.diabetesjournals.org on 4 April 2008.
-
Readers may use this article as long as the work is properly cited, the use is educational and not for profit,and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.
-
The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
-
- Accepted March 28, 2008.
- Received January 4, 2008.
- DIABETES
