PMID- 27459536
OWN - NLM
STAT- MEDLINE
DCOM- 20170630
LR  - 20221207
IS  - 1945-7197 (Electronic)
IS  - 0021-972X (Linking)
VI  - 101
IP  - 10
DP  - 2016 Oct
TI  - Urinary Haptoglobin Predicts Rapid Renal Function Decline in Asians With Type 2 
      Diabetes and Early Kidney Disease.
PG  - 3794-3802
AB  - CONTEXT: A recent study suggested that urinary haptoglobin may be a novel 
      biomarker to improve predictive performance of albuminuria in type 2 diabetes 
      mellitus (T2DM). However, the finding has not been externally validated. 
      OBJECTIVE: The objective of the study was to evaluate whether urinary haptoglobin 
      improves predictive performance of albuminuria in Asian T2DM with an estimated 
      glomerular filtration rate (eGFR) of 30 mL/min per 1.73 m(2) or greater. DESIGN 
      AND PARTICIPANTS: This was a prospective study with 269 T2DM nonprogressors (eGFR 
      changes 0.2 [-0.7 to 1.0] mL/min per 1.73 m(2) per y) and 153 T2DM progressors 
      (eGFR decline -7.1 [-10.6 to -5.1] mL/min per 1.73 m(2) per y) included. MAIN 
      OUTCOME: The main outcome was an eGFR decline of 3 mL/min per 1.73 m(2) or 
      greater per year by trajectory slope. RESULTS: Urinary haptoglobin level 
      increased 11-fold in progressors as compared with nonprogressors at baseline. In 
      comparison with subjects in the lowest quartile, those with haptoglobin in the 
      third and fourth quartiles had 2.25- (1.11-4.59) and 5.41 (2.63-11.1)-fold 
      increased odds for renal progression, whereas those with an albuminuria level in 
      the third and fourth quartiles had 2.53- (1.17-5.51) and 9.01 (4.00-20.5)-fold 
      increased odds. Notably, urinary haptoglobin predicted renal progression 
      independent of albuminuria. Addition of haptoglobin significantly improved the 
      predictive performance of albuminuria beyond traditional risk factors as 
      reflected by a significant increase in the net reclassification index and 
      integrated discrimination index. In the chronic kidney disease stage 3 
      subpopulation, urinary haptoglobin outperformed albuminuria for the prediction of 
      rapid renal function decline. CONCLUSIONS: Our data confirmed that urinary 
      haptoglobin may improve the predictive performance of albuminuria for renal 
      progression in Asians with T2DM. Moreover, it may potentially outperform 
      albuminuria for the prediction of rapid renal function decline in the T2DM 
      chronic kidney disease stage 3 subpopulation.
FAU - Liu, Jian-Jun
AU  - Liu JJ
AD  - Clinical Research Unit (J.-J.L., S.L., M.D.S.W., R.L.G.) and Diabetes Centre 
      (S.C.L.), Khoo Teck Puat Hospital, Singapore 768828.
FAU - Liu, Sylvia
AU  - Liu S
AD  - Clinical Research Unit (J.-J.L., S.L., M.D.S.W., R.L.G.) and Diabetes Centre 
      (S.C.L.), Khoo Teck Puat Hospital, Singapore 768828.
FAU - Wong, Melvin D S
AU  - Wong MD
AD  - Clinical Research Unit (J.-J.L., S.L., M.D.S.W., R.L.G.) and Diabetes Centre 
      (S.C.L.), Khoo Teck Puat Hospital, Singapore 768828.
FAU - Gurung, Resham Lal
AU  - Gurung RL
AD  - Clinical Research Unit (J.-J.L., S.L., M.D.S.W., R.L.G.) and Diabetes Centre 
      (S.C.L.), Khoo Teck Puat Hospital, Singapore 768828.
FAU - Lim, Su Chi
AU  - Lim SC
AD  - Clinical Research Unit (J.-J.L., S.L., M.D.S.W., R.L.G.) and Diabetes Centre 
      (S.C.L.), Khoo Teck Puat Hospital, Singapore 768828.
LA  - eng
PT  - Journal Article
DEP - 20160726
PL  - United States
TA  - J Clin Endocrinol Metab
JT  - The Journal of clinical endocrinology and metabolism
JID - 0375362
RN  - 0 (Biomarkers)
RN  - 0 (Haptoglobins)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Albuminuria/*urine
MH  - Asian People/*ethnology
MH  - Biomarkers/urine
MH  - Diabetes Mellitus, Type 2/complications/ethnology/*urine
MH  - Diabetic Nephropathies/ethnology/etiology/*urine
MH  - Disease Progression
MH  - Female
MH  - *Glomerular Filtration Rate
MH  - Haptoglobins/*urine
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - Singapore/ethnology
EDAT- 2016/07/28 06:00
MHDA- 2017/07/01 06:00
CRDT- 2016/07/27 06:00
PHST- 2016/07/28 06:00 [pubmed]
PHST- 2017/07/01 06:00 [medline]
PHST- 2016/07/27 06:00 [entrez]
AID - 10.1210/jc.2016-2094 [doi]
PST - ppublish
SO  - J Clin Endocrinol Metab. 2016 Oct;101(10):3794-3802. doi: 10.1210/jc.2016-2094. 
      Epub 2016 Jul 26.