Journal
REDOX BIOLOGY
Volume 13, Issue -, Pages 363-369Publisher
ELSEVIER
DOI: 10.1016/j.redox.2017.06.005
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Funding
- Research Committee at Copenhagen University Hospital - Rigshospitalet (Rigshospitalets Forskningsudvalg)
- Research Committee at Bispebjerg Hospital (Bispebjerg Hospitals Forskningsudvalg)
- Capital Region of Denmark (Region Hovedstaden)
- Danish Medical Research Council
- Aase and Ejnar Danielsen Foundation
- P. Carl Petersen Foundation
- Augustinus Foundation
- Lundbeck Foundation
- Danish Research Foundation for General Practice
- Health Insurance Foundation
- Danish Ministry of Health
- Novo Nordisk Farmaka Denmark Ltd.
- A.P. Moller Foundation for the Advancement of Medical Science
- Pharmacy Foundation
- Steno Diabetes Center Copenhagen (SDCC) [SDCC 3.A Complications] Funding Source: researchfish
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Urinary albumin is an important biomarker used to identify high risk patients with diabetes, but there is a need for new biomarkers that alone or in combination with urinary albumin could give an even better prediction of clinical patient outcomes. One promising biomarker is 8-oxo-7,8-dihydroguanosine (8-oxoGuo) that represents intracellular oxidative stress. We investigated the ability of microalbuminuria (MA) and urinary 8-oxoGuo, alone and in combination, to predict mortality and cardiovascular disease (CVD) in patients with type 2 diabetes. We used data from 1381 newly diagnosed diabetes patients, and urinary albumin and 8-oxoGuo were assessed in morning urine collected at the time of diabetes diagnosis and at a follow-up visit 6 years later. Associations between the urinary markers and mortality and CVD were assessed in Cox proportional hazards regression models. Test performance was assessed using sensitivity, specificity, positive predictive value and negative predictive value for 10-year mortality and 10-year incidence of CVD. Both 8-oxoGuo and urinary albumin were statistically significantly associated with all-cause mortality at diagnosis as well as at 6-year follow-up. At diagnosis only urinary albumin was associated with CVD. In contrast, only 8-oxoGuo was associated with CVD at 6-year follow-up. When investigating test performance, we found that by combining information from MA and 8-oxoGuo the ability to correctly identify patients at risk could be improved. The findings suggest that measurement of urinary 8-oxoGuo provides additional information about risk to that obtained from urinary albumin, and that the combined use of 8-oxoGuo and urinary albumin could be useful for a better identification of patients at risk of CVD and death.
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