Advanced

Urine α-Glutathione S-Transferase, systemic inflammation and arterial function in juvenile type 1 diabetes.

Holmquist, Peter LU and Liuba, Petru LU (2012) In Journal of Diabetes and its Complications 26(3). p.199-204
Abstract
BACKGROUND: Despite marked improvement in therapy and monitoring of patients with insulin-dependent (type 1) diabetes, diabetic nephropathy remains a serious complication, with subsequent end-stage renal disease in about 20% of cases.



OBJECTIVE: To investigate in young patients with type 1 diabetes whether urine α-Glutathione S-transferase to creatinine ratio (α-GST:crea) relates to markers of systemic inflammation and subclinical vasculopathy.



DESIGN: Children and adolescents (median age and diabetes duration 14 and 6years, respectively) with type 1 diabetes screened in a previous study for proximal tubular (urine α-GST:crea ratio) and renal (plasma creatinine, cystatin C glomerular filtration rate... (More)
BACKGROUND: Despite marked improvement in therapy and monitoring of patients with insulin-dependent (type 1) diabetes, diabetic nephropathy remains a serious complication, with subsequent end-stage renal disease in about 20% of cases.



OBJECTIVE: To investigate in young patients with type 1 diabetes whether urine α-Glutathione S-transferase to creatinine ratio (α-GST:crea) relates to markers of systemic inflammation and subclinical vasculopathy.



DESIGN: Children and adolescents (median age and diabetes duration 14 and 6years, respectively) with type 1 diabetes screened in a previous study for proximal tubular (urine α-GST:crea ratio) and renal (plasma creatinine, cystatin C glomerular filtration rate (GFR), and timed urine albumin excretion rate (AER)) function were, within the same timeframe, also investigated for vascular (blood pressure, carotid artery intima-media thickness (IMT) and compliance (CAC), brachial artery flow-mediated dilatation (FMD) and plasma cyclic guanosine monophosphate (cGMP) and inflammatory (C-reactive protein (CRP), and tumor necrosis factor-alpha (TNF-α)) profiles. Exposure to environmental tobacco smoke (ETS) was assessed through questionnaire (n=67 respondents).



RESULTS: None of the patients (n=69) had overt renal insufficiency. AER correlated with age (p=0.01, r=0.3), diabetes duration (p=0.02, r=0.3), FMD (p=0.04, r=-0.3, n=52), CAC (p=0.03, r=-0.3, n=62) and cGMP (p=0.01, r=-0.3, n=59). α-GST:crea was lower (p=0.03) in patients than in controls. α-GST:crea appeared to be particularly lower in older patients (p=0.004, r=-0.34 vs age), in those with worse diabetic control (p=0.03, r=-0.26 vs HbA1c), and in those with lower carotid artery elasticity (p=0.017, r=0.3 vs CAC). Although ETS had no direct significant impact on α-GST:crea, α-GST:crea correlated with FMD only in patients with ETS (r=0.5, p=0.009, n=13). α-GST:crea showed positive association with TNF-α (p=0.01, r=0.3).



CONCLUSION: In children and adolescents with type 1 diabetes, lower levels of urine excretion of α-GST:crea appear to be associated with decreasing elasticity and endothelial vasomotor function of peripheral arteries, especially in patients with ETS. In contrast, higher levels of α-GST:crea are more common in patients with elevated markers of systemic inflammation. Large scale prospective studies are needed to clarify the meaning and mechanisms of this association. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Vascular endothelial function, alpha-GST, Inflammation, Type 1 diabetes
in
Journal of Diabetes and its Complications
volume
26
issue
3
pages
199 - 204
publisher
Elsevier
external identifiers
  • wos:000305362500008
  • pmid:22534514
  • scopus:84861641994
ISSN
1873-460X
DOI
10.1016/j.jdiacomp.2012.03.023
language
English
LU publication?
yes
id
13eb87d1-67e1-432d-a870-d8de5ff33025 (old id 2519035)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/22534514?dopt=Abstract
date added to LUP
2012-05-06 21:41:11
date last changed
2017-01-01 03:43:24
@article{13eb87d1-67e1-432d-a870-d8de5ff33025,
  abstract     = {BACKGROUND: Despite marked improvement in therapy and monitoring of patients with insulin-dependent (type 1) diabetes, diabetic nephropathy remains a serious complication, with subsequent end-stage renal disease in about 20% of cases. <br/><br>
<br/><br>
OBJECTIVE: To investigate in young patients with type 1 diabetes whether urine α-Glutathione S-transferase to creatinine ratio (α-GST:crea) relates to markers of systemic inflammation and subclinical vasculopathy.<br/><br>
<br/><br>
DESIGN: Children and adolescents (median age and diabetes duration 14 and 6years, respectively) with type 1 diabetes screened in a previous study for proximal tubular (urine α-GST:crea ratio) and renal (plasma creatinine, cystatin C glomerular filtration rate (GFR), and timed urine albumin excretion rate (AER)) function were, within the same timeframe, also investigated for vascular (blood pressure, carotid artery intima-media thickness (IMT) and compliance (CAC), brachial artery flow-mediated dilatation (FMD) and plasma cyclic guanosine monophosphate (cGMP) and inflammatory (C-reactive protein (CRP), and tumor necrosis factor-alpha (TNF-α)) profiles. Exposure to environmental tobacco smoke (ETS) was assessed through questionnaire (n=67 respondents). <br/><br>
<br/><br>
RESULTS: None of the patients (n=69) had overt renal insufficiency. AER correlated with age (p=0.01, r=0.3), diabetes duration (p=0.02, r=0.3), FMD (p=0.04, r=-0.3, n=52), CAC (p=0.03, r=-0.3, n=62) and cGMP (p=0.01, r=-0.3, n=59). α-GST:crea was lower (p=0.03) in patients than in controls. α-GST:crea appeared to be particularly lower in older patients (p=0.004, r=-0.34 vs age), in those with worse diabetic control (p=0.03, r=-0.26 vs HbA1c), and in those with lower carotid artery elasticity (p=0.017, r=0.3 vs CAC). Although ETS had no direct significant impact on α-GST:crea, α-GST:crea correlated with FMD only in patients with ETS (r=0.5, p=0.009, n=13). α-GST:crea showed positive association with TNF-α (p=0.01, r=0.3). <br/><br>
<br/><br>
CONCLUSION: In children and adolescents with type 1 diabetes, lower levels of urine excretion of α-GST:crea appear to be associated with decreasing elasticity and endothelial vasomotor function of peripheral arteries, especially in patients with ETS. In contrast, higher levels of α-GST:crea are more common in patients with elevated markers of systemic inflammation. Large scale prospective studies are needed to clarify the meaning and mechanisms of this association.},
  author       = {Holmquist, Peter and Liuba, Petru},
  issn         = {1873-460X},
  keyword      = {Vascular endothelial function,alpha-GST,Inflammation,Type 1 diabetes},
  language     = {eng},
  number       = {3},
  pages        = {199--204},
  publisher    = {Elsevier},
  series       = {Journal of Diabetes and its Complications},
  title        = {Urine α-Glutathione S-Transferase, systemic inflammation and arterial function in juvenile type 1 diabetes.},
  url          = {http://dx.doi.org/10.1016/j.jdiacomp.2012.03.023},
  volume       = {26},
  year         = {2012},
}