Urinary albumin excretion is correlated to fibrinogen levels and protein S activity in patients with type 1 diabetes mellitus without overt diabetic nephropathy

Zoltán Lengyel, Péter Vörös, Lajos K. Tóth, Csilla Németh, László Kammerer, Mária Mihály, László Tornóci, L. Rosivall

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Abstract

The aim of the study was to test the hypothesis that in diabetic patients without overt nephropathy there may be a correlation between the activity of natural anticoagulant proteins and glomerular dysfunction. Assays for functional activity of proteins S and C, measurements of urinary albumin excretion, lipid parameters and haemoglobin A1c were performed in 91 patients with type 1 diabetes mellitus and 85 patients with type 2. Patients with type 1 diabetes and microalbuminuria had significantly higher mean age (44.1 ± 10.9 vs. 37.9 ± 12.7 years; p <0.05), fibrinogen level (3.75 ± 1.0 vs. 3.21 ± 0.8 g/l; p <0.01), protein S activity (92.3 ± 17.6 vs. 84.5 ± 15.5%; p <0.05) and higher prevalence of retinopathy (p <0.01) and macrovascular disease (p <0.01) than those with normoalbuminuria. Albumin excretion was significantly correlated to age (r = 0.25, p <0.05), fibrinogen level (r = 0.39, p <0.01), protein S activity (r = 0.27; p <0.05), total cholesterol (r = 0.23; p <0.05), apoprotein B (r = 0.22; p <0.05), retinopathy (r = 0.33; p <0.01) and macrovascular disease (r = 0.33; p <0.01). Patients with type 2 diabetes mellitus and microalbuminuria had significantly higher apoprotein B levels (1.17 ± 0.3 vs. 1.06 ± 1,2 mg/dl; p <0.05) than those with normoalbuminuria, and apoprotein B was significantly correlated to albumin excretion (r = 0.22; p <0.05). In a multivariate model of type 1 diabetes mellitus with fibrinogen, protein S and C activity, cholesterol, triglycerides, haemoglobin A1c, retinopathy, and macrovascular disease as independent parameters (r = 0.53; p <0.003), there was significant independent correlation of fibrinogen (β = 0.28; p <0.01), protein S activity (β = 0.27; p <0.05) and retinopathy (β = 0.21; p <0.01) with albumin excretion. We conclude that in type 1 diabetes, relative elevation of fibrinogen level and protein S activity appear in the early stages of development of diabetic nephropathy, and may be related to the pathogenesis of diabetic kidney disease.

Original languageEnglish
Pages (from-to)240-245
Number of pages6
JournalWiener Klinische Wochenschrift
Volume116
Issue number7-8
Publication statusPublished - Apr 30 2004

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Protein S
Diabetic Nephropathies
Type 1 Diabetes Mellitus
Fibrinogen
Albumins
Apolipoproteins B
Protein C
Hemoglobins
Cholesterol
Anticoagulants
Type 2 Diabetes Mellitus
Triglycerides
Lipids
Proteins

Keywords

  • Diabetes mellitus
  • Fibrinogen
  • Microalbuminuria
  • Protein S

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Urinary albumin excretion is correlated to fibrinogen levels and protein S activity in patients with type 1 diabetes mellitus without overt diabetic nephropathy. / Lengyel, Zoltán; Vörös, Péter; Tóth, Lajos K.; Németh, Csilla; Kammerer, László; Mihály, Mária; Tornóci, László; Rosivall, L.

In: Wiener Klinische Wochenschrift, Vol. 116, No. 7-8, 30.04.2004, p. 240-245.

Research output: Contribution to journalArticle

Lengyel, Zoltán ; Vörös, Péter ; Tóth, Lajos K. ; Németh, Csilla ; Kammerer, László ; Mihály, Mária ; Tornóci, László ; Rosivall, L. / Urinary albumin excretion is correlated to fibrinogen levels and protein S activity in patients with type 1 diabetes mellitus without overt diabetic nephropathy. In: Wiener Klinische Wochenschrift. 2004 ; Vol. 116, No. 7-8. pp. 240-245.
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abstract = "The aim of the study was to test the hypothesis that in diabetic patients without overt nephropathy there may be a correlation between the activity of natural anticoagulant proteins and glomerular dysfunction. Assays for functional activity of proteins S and C, measurements of urinary albumin excretion, lipid parameters and haemoglobin A1c were performed in 91 patients with type 1 diabetes mellitus and 85 patients with type 2. Patients with type 1 diabetes and microalbuminuria had significantly higher mean age (44.1 ± 10.9 vs. 37.9 ± 12.7 years; p <0.05), fibrinogen level (3.75 ± 1.0 vs. 3.21 ± 0.8 g/l; p <0.01), protein S activity (92.3 ± 17.6 vs. 84.5 ± 15.5{\%}; p <0.05) and higher prevalence of retinopathy (p <0.01) and macrovascular disease (p <0.01) than those with normoalbuminuria. Albumin excretion was significantly correlated to age (r = 0.25, p <0.05), fibrinogen level (r = 0.39, p <0.01), protein S activity (r = 0.27; p <0.05), total cholesterol (r = 0.23; p <0.05), apoprotein B (r = 0.22; p <0.05), retinopathy (r = 0.33; p <0.01) and macrovascular disease (r = 0.33; p <0.01). Patients with type 2 diabetes mellitus and microalbuminuria had significantly higher apoprotein B levels (1.17 ± 0.3 vs. 1.06 ± 1,2 mg/dl; p <0.05) than those with normoalbuminuria, and apoprotein B was significantly correlated to albumin excretion (r = 0.22; p <0.05). In a multivariate model of type 1 diabetes mellitus with fibrinogen, protein S and C activity, cholesterol, triglycerides, haemoglobin A1c, retinopathy, and macrovascular disease as independent parameters (r = 0.53; p <0.003), there was significant independent correlation of fibrinogen (β = 0.28; p <0.01), protein S activity (β = 0.27; p <0.05) and retinopathy (β = 0.21; p <0.01) with albumin excretion. We conclude that in type 1 diabetes, relative elevation of fibrinogen level and protein S activity appear in the early stages of development of diabetic nephropathy, and may be related to the pathogenesis of diabetic kidney disease.",
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T1 - Urinary albumin excretion is correlated to fibrinogen levels and protein S activity in patients with type 1 diabetes mellitus without overt diabetic nephropathy

AU - Lengyel, Zoltán

AU - Vörös, Péter

AU - Tóth, Lajos K.

AU - Németh, Csilla

AU - Kammerer, László

AU - Mihály, Mária

AU - Tornóci, László

AU - Rosivall, L.

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N2 - The aim of the study was to test the hypothesis that in diabetic patients without overt nephropathy there may be a correlation between the activity of natural anticoagulant proteins and glomerular dysfunction. Assays for functional activity of proteins S and C, measurements of urinary albumin excretion, lipid parameters and haemoglobin A1c were performed in 91 patients with type 1 diabetes mellitus and 85 patients with type 2. Patients with type 1 diabetes and microalbuminuria had significantly higher mean age (44.1 ± 10.9 vs. 37.9 ± 12.7 years; p <0.05), fibrinogen level (3.75 ± 1.0 vs. 3.21 ± 0.8 g/l; p <0.01), protein S activity (92.3 ± 17.6 vs. 84.5 ± 15.5%; p <0.05) and higher prevalence of retinopathy (p <0.01) and macrovascular disease (p <0.01) than those with normoalbuminuria. Albumin excretion was significantly correlated to age (r = 0.25, p <0.05), fibrinogen level (r = 0.39, p <0.01), protein S activity (r = 0.27; p <0.05), total cholesterol (r = 0.23; p <0.05), apoprotein B (r = 0.22; p <0.05), retinopathy (r = 0.33; p <0.01) and macrovascular disease (r = 0.33; p <0.01). Patients with type 2 diabetes mellitus and microalbuminuria had significantly higher apoprotein B levels (1.17 ± 0.3 vs. 1.06 ± 1,2 mg/dl; p <0.05) than those with normoalbuminuria, and apoprotein B was significantly correlated to albumin excretion (r = 0.22; p <0.05). In a multivariate model of type 1 diabetes mellitus with fibrinogen, protein S and C activity, cholesterol, triglycerides, haemoglobin A1c, retinopathy, and macrovascular disease as independent parameters (r = 0.53; p <0.003), there was significant independent correlation of fibrinogen (β = 0.28; p <0.01), protein S activity (β = 0.27; p <0.05) and retinopathy (β = 0.21; p <0.01) with albumin excretion. We conclude that in type 1 diabetes, relative elevation of fibrinogen level and protein S activity appear in the early stages of development of diabetic nephropathy, and may be related to the pathogenesis of diabetic kidney disease.

AB - The aim of the study was to test the hypothesis that in diabetic patients without overt nephropathy there may be a correlation between the activity of natural anticoagulant proteins and glomerular dysfunction. Assays for functional activity of proteins S and C, measurements of urinary albumin excretion, lipid parameters and haemoglobin A1c were performed in 91 patients with type 1 diabetes mellitus and 85 patients with type 2. Patients with type 1 diabetes and microalbuminuria had significantly higher mean age (44.1 ± 10.9 vs. 37.9 ± 12.7 years; p <0.05), fibrinogen level (3.75 ± 1.0 vs. 3.21 ± 0.8 g/l; p <0.01), protein S activity (92.3 ± 17.6 vs. 84.5 ± 15.5%; p <0.05) and higher prevalence of retinopathy (p <0.01) and macrovascular disease (p <0.01) than those with normoalbuminuria. Albumin excretion was significantly correlated to age (r = 0.25, p <0.05), fibrinogen level (r = 0.39, p <0.01), protein S activity (r = 0.27; p <0.05), total cholesterol (r = 0.23; p <0.05), apoprotein B (r = 0.22; p <0.05), retinopathy (r = 0.33; p <0.01) and macrovascular disease (r = 0.33; p <0.01). Patients with type 2 diabetes mellitus and microalbuminuria had significantly higher apoprotein B levels (1.17 ± 0.3 vs. 1.06 ± 1,2 mg/dl; p <0.05) than those with normoalbuminuria, and apoprotein B was significantly correlated to albumin excretion (r = 0.22; p <0.05). In a multivariate model of type 1 diabetes mellitus with fibrinogen, protein S and C activity, cholesterol, triglycerides, haemoglobin A1c, retinopathy, and macrovascular disease as independent parameters (r = 0.53; p <0.003), there was significant independent correlation of fibrinogen (β = 0.28; p <0.01), protein S activity (β = 0.27; p <0.05) and retinopathy (β = 0.21; p <0.01) with albumin excretion. We conclude that in type 1 diabetes, relative elevation of fibrinogen level and protein S activity appear in the early stages of development of diabetic nephropathy, and may be related to the pathogenesis of diabetic kidney disease.

KW - Diabetes mellitus

KW - Fibrinogen

KW - Microalbuminuria

KW - Protein S

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