BACKGROUND:Amadori-albumin, a major glycated protein, is involved in experimental hyperglycaemia-induced microvascular complications, and is associated with advanced nephropathy in Type I diabetic patients in humans. Our aim was to assess the association of Amadori-albumin with early nephropathy and with retinopathy in Type I diabetic patients and the involvement of chronic low-degree inflammation therein. DESIGN AND METHODS: Amadori-albumin, the Amadori product of haemoglobin (HbA1c), C-reactive protein, and fibrinogen levels were measured in the EUCLID study, a 2-year randomised, double-blind, placebo-controlled trial of lisinopril in 447 Type I diabetic patients. Retinal photographs were taken in 341 patients at baseline and 294 at follow up. RESULTS:Amadori-albumin was positively associated with albumin the excretion rate and retinopathy status (P = 0.0001 and P = 0.02 for trend, respectively) and with the progression from normoalbuminuria to (micro)albuminuria (38.6 U mL(-1) in nonprogressors, 44.3 U mL-1 in progressors; P = 0.02), but not with the development or progression of retinopathy during a 2-year follow up. Amadori-albumin levels at baseline were associated with C-reactive protein and fibrinogen (P = 0.0007 and P = 0.0001, respectively). C-reactive protein and fibrinogen were also associated with albumin excretion rates (P = 0.03 and P = 0.01, respectively) and retinopathy status (P = 0.02 and P = 0.0006, respectively). Adjustment for these inflammatory markers did not markedly attenuate the association between Amadori-albumin and the albumin excretion rate, while adjustment for fibrinogen, but not C-reactive protein, abolished the association between Amadori-albumin and retinopathy. Lisinopril had no impact on the association between the levels of Amadori-albumin and albumin excretion rates or retinopathy. CONCLUSIONS:Amadori-albumin was associated with early nephropathy and with retinopathy in Type I diabetic patients and preceded an increase in albumin excretion rate, but not retinopathy. A chronic low-degree inflammation does not appear to be involved in Amadori-albumin-associated microvascular complications in Type I diabetes.
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BACKGROUND: Amadori-albumin, a major glycated protein, is involved in experimental hyperglycaemia-induced microvascular complications, and is associated with advanced nephropathy in Type I diabeticpatients in humans. Our aim was to assess the association of Amadori-albumin with early nephropathy and with retinopathy in Type I diabeticpatients and the involvement of chronic low-degree inflammation therein. DESIGN AND METHODS: Amadori-albumin, the Amadori product of haemoglobin (HbA1c), C-reactive protein, and fibrinogen levels were measured in the EUCLID study, a 2-year randomised, double-blind, placebo-controlled trial of lisinopril in 447 Type I diabeticpatients. Retinal photographs were taken in 341 patients at baseline and 294 at follow up. RESULTS: Amadori-albumin was positively associated with albumin the excretion rate and retinopathy status (P = 0.0001 and P = 0.02 for trend, respectively) and with the progression from normoalbuminuria to (micro)albuminuria (38.6 U mL(-1) in nonprogressors, 44.3 U mL-1 in progressors; P = 0.02), but not with the development or progression of retinopathy during a 2-year follow up. Amadori-albumin levels at baseline were associated with C-reactive protein and fibrinogen (P = 0.0007 and P = 0.0001, respectively). C-reactive protein and fibrinogen were also associated with albumin excretion rates (P = 0.03 and P = 0.01, respectively) and retinopathy status (P = 0.02 and P = 0.0006, respectively). Adjustment for these inflammatory markers did not markedly attenuate the association between Amadori-albumin and the albumin excretion rate, while adjustment for fibrinogen, but not C-reactive protein, abolished the association between Amadori-albumin and retinopathy. Lisinopril had no impact on the association between the levels of Amadori-albumin and albumin excretion rates or retinopathy. CONCLUSIONS: Amadori-albumin was associated with early nephropathy and with retinopathy in Type I diabeticpatients and preceded an increase in albumin excretion rate, but not retinopathy. A chronic low-degree inflammation does not appear to be involved in Amadori-albumin-associated microvascular complications in Type I diabetes.
Authors: Elizabeth Selvin; Lesley M A Francis; Christie M Ballantyne; Ron C Hoogeveen; Josef Coresh; Frederick L Brancati; Michael W Steffes Journal: Diabetes Care Date: 2011-02-18 Impact factor: 19.112
Authors: Johanna W Nin; Anders Jorsal; Isabel Ferreira; Casper G Schalkwijk; Martin H Prins; Hans-Henrik Parving; Lise Tarnow; Peter Rossing; Coen D Stehouwer Journal: Diabetes Care Date: 2011-02 Impact factor: 19.112
Authors: Melinda T Coughlan; Felicia Y T Yap; David C K Tong; Sofianos Andrikopoulos; Anna Gasser; Vicki Thallas-Bonke; Diane E Webster; Jun-Ichi Miyazaki; Thomas W Kay; Robyn M Slattery; David M Kaye; Brian G Drew; Bronwyn A Kingwell; Spiros Fourlanos; Per-Henrik Groop; Leonard C Harrison; Mikael Knip; Josephine M Forbes Journal: Diabetes Date: 2011-09-12 Impact factor: 9.461