ASN 2022: Endotrophin as a marker of complications in the type 2 diabetes cohort

Hyperglycemia-mediated tissue damage eventually leads to fibrosis
that affects various organ systems.
We investigated whether serum and urine endotrophin, a pro-fibrosis signaling molecule, reflecting collagen VI formation, was associated with
the risk of complications in unselected people with type 2 diabetes.

Methods Endotrophin
was measured by PRO-C6 ELISA in serum and urine of 774 patients with type 2 diabetes recruited between 2012 and 2016
.
Normalize urine values to urine creatinine levels
.
Results were determined by national registries and medical records, including composite renal endpoints (≥40% decline in renal function or renal failure), first major cardiovascular adverse event (MACE), all-cause mortality, progression of proteinuria, heart failure events, and vision-threatening eye disease
.
A Cox proportional risk model
adjusted for general risk factors is applied.

Results
The cohort included 254 (33%) women with a mean age of ±SD of 65±12 years, a course of diabetes of 17±8.
8 years, an eGFR of 76 ±24 ml/min/1.
73 m2, and a median [Q1:Q3] urinary albumin excretion of 12.
5 [5.
5:73.
5] mg/g or g/24 hours
.
Depending on the results, the median follow-up was 3.
0 to 6.
0 years
.
Doubling of serum endothelin was independently associated with composite renal endpoints, first MACE, all-cause mortality, and heart failure events, but not with progression of albuminuria or the development of vision-threatening eye disease (table).

Doubling of endotrophin in urine was independently associated with the progression of albuminuria and heart failure events, but not with other outcomes (table).

ConclusionsSerum
endotrophin is a risk marker for
mortality, renal and cardiovascular complications in patients with type 2 diabetes.
Urotrophin is a risk marker for
progression in proteinuria and heart failure events.

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