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Abstract
Urinary podocin and nephrin mRNAs (podocyturia), as candidate biomarkers of endothelial/podocyte injury, were measured by quantitative PCR in Type II diabetics with normal albumin excretion rates (AER) at baseline, at 3–4 years, and at 7 years. Development of cardiovascular disease (CVD) was collected as outcome. Visit 1 podocyturia was significantly higher in subjects who subsequently developed CVD versus those who did not. Visit 1 AER terciles exhibited similar time to CVD, in contrast with stepwise and substantial increases in CVD events predicted by Visit 1 podocyturia terciles. Covariate-adjusted hazard ratios were highest for podocin, intermediate for nephrin mRNAs, and lowest for AER. Podocyturia was also measured in patients with and without significant coronary obstruction, and in 480 normoalbuminuric subjects at the enrolment visit to the Multi-Ethnic Study of Atherosclerosis (MESA). Podocyturia > 3 × 106 copies was associated with presence of obstructive coronary artery disease. In the MESA population, Visit 1 podocyturia was significantly higher in men, subjects with elevated BMI, and those with Type II DM. Conclusions: Podocyturia may be an earlier predictor of cardiovascular events than moderate albuminuria; it is significantly higher in patients with obstructive coronary artery disease, and in subjects with established risk factors for CVD.
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1 American University of Beirut, Department of Anatomy, Cell Biology and Physiology, Beirut, Lebanon (GRID:grid.22903.3a) (ISNI:0000 0004 1936 9801); American University of Beirut, Vascular Medicine Program, Faculty of Medicine, Beirut, Lebanon (GRID:grid.22903.3a) (ISNI:0000 0004 1936 9801)
2 American University of Beirut, Vascular Medicine Program, Faculty of Medicine, Beirut, Lebanon (GRID:grid.22903.3a) (ISNI:0000 0004 1936 9801); American University of Beirut, Department of Internal Medicine, Beirut, Lebanon (GRID:grid.22903.3a) (ISNI:0000 0004 1936 9801)
3 Johns Hopkins University School of Medicine, Department of Cardiology, Baltimore, USA (GRID:grid.21107.35) (ISNI:0000 0001 2171 9311)
4 Massachusetts General Hospital, Department of Emergency Medicine, Boston, USA (GRID:grid.32224.35) (ISNI:0000 0004 0386 9924)
5 American University of Beirut, Department of Internal Medicine, Beirut, Lebanon (GRID:grid.22903.3a) (ISNI:0000 0004 1936 9801); American University of Beirut, Clinical Research Institute, Faculty of Medicine, Beirut, Lebanon (GRID:grid.22903.3a) (ISNI:0000 0004 1936 9801)
6 American University of Beirut, Clinical Research Institute, Faculty of Medicine, Beirut, Lebanon (GRID:grid.22903.3a) (ISNI:0000 0004 1936 9801)