Urinary PGDS levels are associated with vascular injury in type 2 diabetes patients

Yoshikawa, Ritsuko; Wada, Jun; Seiki, Kousuke; Matsuoka, Takashi; Miyamoto, Satoshi; Takahashi, Kenji; Ota, Sachiko; Taniai, Kazuhi; Hida, Kazuyuki; Yamakado, Minoru; Shikata, Kenichi; Uehara, Yoshio; Urade, Yoshihiro; Makino, Hirofumi

doi:10.1016/j.diabres.2006.09.004

« Previous Next »Diabetes Research and Clinical Practice
Volume 76, Issue 3 , Pages 358-367, June 2007

Urinary PGDS levels are associated with vascular injury in type 2 diabetes patients

Ritsuko Yoshikawa
- Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, 2-5-1 Shikata-cho, Okayama 700-8558, Japan
Jun Wada
- Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, 2-5-1 Shikata-cho, Okayama 700-8558, Japan
- Corresponding author. Tel.: +81 86 235 7235; fax: +81 86 222 5214.
Kousuke Seiki
- Central Research Institute, Maruha Group Inc., Tsukuba, Japan
Takashi Matsuoka
- Kurashiki Life Style Disease Center, Kurashiki, Japan
Satoshi Miyamoto
- Diabetes Division, Department of Internal Medicine, Kurashiki Central Hospital, Kurashiki, Japan
Kenji Takahashi
- Diabetes Division, Department of Internal Medicine, Kurashiki Central Hospital, Kurashiki, Japan
Sachiko Ota
- Department of Medicine, Okayama Central Hospital, Okayama, Japan
Kazuhi Taniai
- Department of Medicine, Okayama Central Hospital, Okayama, Japan
Kazuyuki Hida
- Department of Medicine, National Hospital Organization Okayama Medical Center, Okayama, Japan
Minoru Yamakado
- Health Service Center, Mitui Memorial Hospital, Tokyo, Japan
Kenichi Shikata
- Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, 2-5-1 Shikata-cho, Okayama 700-8558, Japan
Yoshio Uehara
- Health Service Center, University of Tokyo, Tokyo, Japan
Yoshihiro Urade
- Department of Molecular Behavioral Biology, Osaka Bioscience Institute, Osaka, Japan
Hirofumi Makino
- Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, 2-5-1 Shikata-cho, Okayama 700-8558, Japan

Received 19 May 2006; accepted 4 September 2006. published online 28 September 2006.

Abstract

Background

The presence of metabolic syndrome has been shown to be predictors of cardiovascular morbidity and mortality in patients with type 2 diabetes. In a cross-sectional clinical study, we investigated the association of metabolic syndrome with asymptomatic lacunar strokes and cardiovascular disease (CVD) and we compared its significance with urinary protein markers.

Methods

We studied Japanese type 2 diabetes patients (n=233, men=124, women=109). The diagnosis of metabolic syndrome was made according to WHO and International Diabetes Federation (IDF) criteria. Cardiovascular events were recorded and asymptomatic lacunar lesions were evaluated with magnetic resonance imaging (MRI). We also measured urinary levels of albumin, type IV collagen, β2-microglobulin (β2MG), N-acetyl-β-d-glucosaminidase (NAG) and lipocalin-type prostaglandin D synthase (PGDS).

Results

The prevalence of metabolic syndrome is 31.3% (IDF) and 52% (WHO) in 233 patients and microalbuminuria was present in 62 subjects (26.6%). Metabolic syndrome (WHO) significantly associated with asymptomatic lacunar lesions (p=0.035, OR=2.854, CI 1.075–7.579), while metabolic syndrome (IDF) or urinary markers failed to associate with presence of asymptomatic lacunar lesions. The presence of metabolic syndrome or microalbuminuria did not show significant association with CVD; however, the elevation of β2MG, NAG and PGDS showed significant association with CVD. By a logistic regression analysis using urinary proteins as independent variables, the presence of higher PGDS excretion independently associated with history of CVD (p=0.025, OR=3.847, CI 1.180–12.545).

Conclusions

In type 2 diabetes patients, the elevation of urinary PGDS secretion closely associated with cardiovascular events and may be a supplemental or additional marker to the criteria of metabolic syndrome.

Keywords: Metabolic syndrome, Microalbuminuria, Cardiovascular disease, Type 2 diabetes, Atherosclerosis