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Maria Gomez

Maria Gomez

Professor

Maria Gomez

Validation of Plasma Biomarker Candidates for the Prediction of eGFR Decline in Patients With Type 2 Diabetes

Author

  • Andreas Heinzel
  • Michael Kammer
  • Gert Mayer
  • Roman Reindl-Schwaighofer
  • Karin Hu
  • Paul Perco
  • Susanne Eder
  • Laszlo Rosivall
  • Patrick B. Mark
  • Wenjun Ju
  • Matthias Kretzler
  • Peter Gilmour
  • Jonathan M. Wilson
  • Kevin L. Duffin
  • Moustafa Abdalla
  • Mark I. McCarthy
  • Georg Heinze
  • Hiddo L. Heerspink
  • Andrzej Wiecek
  • Maria F. Gomez
  • Rainer Oberbauer

Summary, in English

RESEARCH DESIGN AND METHODS: We studied participants in PROVALID (PROspective cohort study in patients with type 2 diabetes mellitus for VALIDation of biomarkers), a prospective multinational cohort study of patients with type 2 diabetes and a follow-up of more than 24 months (n = 2,560; baseline median eGFR, 84 mL/min/1.73 m2; urine albumin-to-creatinine ratio, 8.1 mg/g). The 17 biomarkers were measured at baseline in 481 samples using Luminex and ELISA. The prediction of eGFR decline was evaluated by linear mixed modeling.

RESULTS: In univariable analyses, 9 of the 17 markers showed significant differences in median concentration between stable and fast-progressing patients. A linear mixed model for eGFR obtained by variable selection exhibited an adjusted R2 of 62%. A panel of 12 biomarkers was selected by the procedure and accounted for 34% of the total explained variability, of which 32% was due to 5 markers. The individual contribution of each biomarker to the prediction of eGFR decline on top of clinical predictors was generally low. When included into the model, baseline eGFR exhibited the largest explained variability of eGFR decline (R2 of 79%), and the contribution of each biomarker dropped below 1%.

CONCLUSIONS: In this longitudinal study of patients with type 2 diabetes and maintained eGFR at baseline, 12 of the 17 candidate biomarkers were associated with eGFR decline, but their predictive power was low.

OBJECTIVE: The decline of estimated glomerular filtration rate (eGFR) in patients with type 2 diabetes is variable, and early interventions would likely be cost-effective. We elucidated the contribution of 17 plasma biomarkers to the prediction of eGFR loss on top of clinical risk factors.

Department/s

  • Diabetic Complications
  • EXODIAB: Excellence in Diabetes Research in Sweden

Publishing year

2018

Language

English

Pages

1947-1954

Publication/Series

Diabetes Care

Volume

41

Issue

9

Document type

Journal article

Publisher

American Diabetes Association

Topic

  • Endocrinology and Diabetes

Status

Published

Research group

  • Diabetic Complications

ISBN/ISSN/Other

  • ISSN: 1935-5548