Serum Vascular Adhesion Protein-1 Predicts End-Stage Renal Disease in Patients with Type 2 Diabetes

doi:10.1371/journal.pone.0147981

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Title:	Serum Vascular Adhesion Protein-1 Predicts End-Stage Renal Disease in Patients with Type 2 Diabetes
Authors:	Li, Hung-Yuan Lin, Hung-An Nien, Feng-Jung Wu, Vin-Cent Jiang, Yi-Der Chang, Tien-Jyun Kao, Hsien-Li Lin, Mao-Shin Wei, Jung-Nan Lin, Cheng-Hsin Shih, Shyang-Rong Hung, Chi-Sheng Chuang, Lee-Ming
Contributors:	Natl Taiwan Univ Hosp, Dept Internal Med Minist Hlth & Welf, Lo Sheng Sanat & Hosp Natl Taiwan Univ Hosp, Yun Lin Branch, Dept Internal Med Natl Taiwan Univ, Coll Med, Grad Inst Clin Med Chia Nan Univ Pharm & Sci Taipei Med Univ, Wan Fang Hosp, Dept Surg, Div Cardiovasc Surg Natl Taiwan Univ, Sch Publ Hlth, Grad Inst Prevent Med
Keywords:	sensitive amine oxidase chronic kidney-disease risk-factors complications mortality inflammation dialysis markers people taiwan
Date:	2016-02
Issue Date:	2018-01-18 11:37:51 (UTC+8)
Publisher:	Public Library Science
Abstract:	Background Diabetes is the leading cause of end-stage renal disease (ESRD) worldwide. Vascular adhesion protein-1 (VAP-1) participates in inflammation and catalyzes the deamination of primary amines into aldehydes, hydrogen peroxide, and ammonia, both of which are involved in the pathogenesis of diabetic complications. We have shown that serum VAP-1 is higher in patients with diabetes and in patients with chronic kidney disease (CKD), and can predict cardiovascular mortality in subjects with diabetes. In this study, we investigated if serum VAP-1 can predict ESRD in diabetic subjects. Methods In this prospective cohort study, a total of 604 type 2 diabetic subjects were enrolled between 1996 to 2003 at National Taiwan University Hospital, Taiwan, and were followed for a median of 12.36 years. The development of ESRD was ascertained by linking our database with the nationally comprehensive Taiwan Society Nephrology registry. Serum VAP-1 concentrations at enrollment were measured by time-resolved immunofluorometric assay. Results Subjects with serum VAP-1 in the highest tertile had the highest incidence of ESRD (p<0.001). Every 1-SD increase in serum VAP-1 was associated with a hazard ratio of 1.55 (95% CI 1.12-2.14, p<0.01) for the risk of ESRD, adjusted for smoking, history of cardiovascular disease, body mass index, hypertension, HbA1c, duration of diabetes, total cholesterol, use of statins, ankle-brachial index, estimated GFR, and proteinuria. We developed a risk score comprising serum VAP-1, HbA1c, estimated GFR, and proteinuria, which could predict ESRD with good performance (area under the ROC curve = 0.9406, 95% CI 0.8871-0.9941, sensitivity = 77.3%, and specificity = 92.8%). We also developed an algorithm based on the stage of CKD and a risk score including serum VAP-1, which can stratify these subjects into 3 categories with an ESRD risk of 0.101%/year, 0.131%/year, and 2.427%/year, respectively. Conclusions In conclusion, serum VAP-1 can predict ESRD and is a useful biomarker to improve risk stratification in type 2 diabetic subjects.
Relation:	Plos One, v.11 n.2, e0147981
Appears in Collections:	[Dept. of Occupational Safety] Periodical Articles

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