Endothelial dysfunction markers syndecan-1 and thrombomodulin are associated with higher albuminuria levels in type 2 diabetes with no history of clinical cardiovascular disease

J Diabetes Complications. 2024 Nov;38(11):108879. doi: 10.1016/j.jdiacomp.2024.108879. Epub 2024 Oct 9.

Abstract

Introduction: Individuals with type 2 diabetes and increased albuminuria, a well-established marker of microvascular complications, are at a higher risk for cardiovascular disease (CVD) and premature mortality. Therefore, a better understanding of the underlying pathophysiology is needed to improve risk stratification and tailor prevention and intervention.

Methods: We conducted a cross-sectional study including 463 individuals with type 2 diabetes, various degrees of albuminuria and without CVD. We analysed the association between albuminuria and markers of endothelial function (thrombomodulin and syndecan-1), thrombin generation (thrombin-antithrombin complex, prothrombin fragment 1 + 2), fibrinogen, platelet function (activation using soluble plasma selectin and aggregation using Multiplate® Analyzer) using regression models.

Results: In the study cohort 33 % were women, the mean ± SD age was 65 ± 9 years, and median [IQR] diabetes duration was 15 [9-20] years. In total, 344 (74 %) individuals had normal albuminuria, 87 (19 %) moderately- and 32 (7 %) severely increased albuminuria levels. Higher markers of endothelial function and fibrinogen were independently associated with higher albuminuria levels (p < 0.01). No association between albuminuria and markers of thrombin generation and platelet was demonstrated.

Conclusion: We demonstrated an independent association between albuminuria and markers of endothelial function and fibrinogen in individuals with type 2 diabetes and no history of CVD.

Keywords: Albuminuria; Cardiovascular disease; Endothelial function; Platelet function; Thrombin generation; Type 2 diabetes.

MeSH terms

  • Aged
  • Albuminuria* / blood
  • Biomarkers* / blood
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / physiopathology
  • Cohort Studies
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2* / blood
  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / physiopathology
  • Diabetic Angiopathies / blood
  • Diabetic Angiopathies / diagnosis
  • Diabetic Angiopathies / epidemiology
  • Diabetic Angiopathies / physiopathology
  • Diabetic Nephropathies / blood
  • Diabetic Nephropathies / diagnosis
  • Diabetic Nephropathies / epidemiology
  • Diabetic Nephropathies / physiopathology
  • Endothelium, Vascular* / physiopathology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Syndecan-1* / blood
  • Thrombomodulin* / blood

Substances

  • Thrombomodulin
  • Biomarkers
  • Syndecan-1
  • SDC1 protein, human
  • THBD protein, human