Urinary Adiponectin Excretion

A Novel Marker for Vascular Damage in Type 2 Diabetes

  1. Maximilian von Eynatten1,2,
  2. Dan Liu1,
  3. Cornelia Hock3,
  4. Dimitrios Oikonomou2,
  5. Marcus Baumann1,
  6. Bruno Allolio3,
  7. Grigorios Korosoglou2,
  8. Michael Morcos2,
  9. Valentina Campean4,
  10. Kerstin Amann4,
  11. Jens Lutz1,
  12. Uwe Heemann1,
  13. Peter P. Nawroth2,
  14. Angelika Bierhaus2 and
  15. Per M. Humpert2
  1. 1Department of Nephrology, Technische Universitat Muenchen, Ismaningerstr, Munich, Germany;
  2. 2Department of Medicine I and Clinical Chemistry and Medicine III, Heidelberg University, Im Neuenheimer Feld, Heidelberg, Germany;
  3. 3Department of Medicine I, Wuerzburg University, Josef-Schneider-Str.2, Wuerzburg, Germany;
  4. 4Department of Pathology, Erlangen University, Krankenhausstrasse, Erlangen, Germany.
  1. Corresponding author: Maximilian von Eynatten, maximilian.eynatten{at}lrz.tum.de.

Abstract

OBJECTIVE Markers reliably identifying vascular damage and risk in diabetic patients are rare, and reports on associations of serum adiponectin with macrovascular disease have been inconsistent. In contrast to existing data on serum adiponectin, this study assesses whether urinary adiponectin excretion might represent a more consistent vascular damage marker in type 2 diabetes.

RESEARCH DESIGN AND METHODS Adiponectin distribution in human kidney biopsies was assessed by immunohistochemistry, and urinary adiponectin isoforms were characterized by Western blot analysis. Total urinary adiponectin excretion rate was measured in 156 patients with type 2 diabetes who had a history of diabetic nephropathy and 40 healthy control subjects using enzyme-linked immunosorbent assay. Atherosclerotic burden was assessed by common carotid artery intima-media-thickness (IMT).

RESULTS A homogenous staining of adiponectin was found on the endothelial surface of glomerular capillaries and intrarenal arterioles in nondiabetic kidneys, whereas staining was decreased in diabetic nephropathy. Low-molecular adiponectin isoforms (∼30–70 kDa) were detected in urine by Western blot analysis. Urinary adiponectin was significantly increased in type 2 diabetes (7.68 ± 14.26 vs. control subjects: 2.91 ± 3.85 μg/g creatinine, P = 0.008). Among type 2 diabetic patients, adiponectinuria was associated with IMT (r = 0.479, P < 0.001) and proved to be a powerful independent predictor of IMT (β = 0.360, P < 0.001) in multivariable regression analyses. In a risk prediction model including variables of the UK Prospective Diabetes Study coronary heart disease risk engine urinary adiponectin, but not the albumin excretion rate, added significant value for the prediction of increased IMT (P = 0.007).

CONCLUSIONS Quantification of urinary adiponectin excretion appears to be an independent indicator of vascular damage potentially identifying an increased risk for vascular events.

Footnotes

  • 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.

    • Received February 14, 2009.
    • Accepted May 18, 2009.
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This Article

  1. Diabetes vol. 58 no. 9 2093-2099
  1. All Versions of this Article:
    1. db09-0204v1
    2. 58/9/2093 most recent