| Pregnancy-associated plasma protein A in a large cohort of Type 1 diabetic patients with and without diabetic nephropathy-a prospective follow--up study. | |
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MedLine Citation:
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PMID: 17971180 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIM: Pregnancy-associated plasma protein A (PAPP-A) has been implicated in the aetiology of acute coronary syndromes and carotid and peripheral artherosclerosis. Diabetic nephropathy is characterized by increased cardiovascular risk. We investigated the prognostic value of PAPP-A in a large cohort of Type 1 diabetic patients. METHODS: In a prospective observational follow-up study, 197 Type 1 diabetic patients with diabetic nephropathy and a matched group of 178 patients with normoalbuminuria were followed for 10.1 (0-10.3) years. PAPP-A was determined at baseline. RESULTS: In patients with diabetic nephropathy, plasma PAPP-A was elevated 3.6 (0.4-51.1) mIU/l [median (range)] vs. 2.1 (0.4-46.6) mIU/l in normoalbuminuric patients, P < 0.0001. For acute coronary syndromes, a PAPP-A threshold of 10 mIU/l has been suggested. Thirty-seven patients were above the threshold and of these 13 patients (35%) died, compared with 60 of 338 patients (18%) below the threshold; log rank test P = 0.007. PAPP-A significantly predicted mortality after adjustment for presence of nephropathy; hazard ratio for dying when PAPP-A was above the threshold 2.1 (95% CI 1.13-3.9); P = 0.019. After adjusting for traditional risk factors, the results were attenuated. When only patients with nephropathy were analysed, PAPP-A was significantly predictive of all-cause mortality [P = 0.008; 2.43 (1.26-4.67)] in unadjusted analysis. After adjustment, the predictive value of PAPP-A for all-cause mortality was attenuated (P = 0.064). CONCLUSION: We find PAPP-A to be associated with increased mortality in Type 1 diabetic patients with nephropathy in unadjusted analysis. After adjustment for traditional risk factors, the prognostic value of PAPP-A was no longer significant. |
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Authors:
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A S Astrup; L Tarnow; M Christiansen; P R Hansen; H-H Parving; P Rossing |
Publication Detail:
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Type: Journal Article Date: 2007-10-29 |
Journal Detail:
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Title: Diabetic medicine : a journal of the British Diabetic Association Volume: 24 ISSN: 0742-3071 ISO Abbreviation: Diabet. Med. Publication Date: 2007 Dec |
Date Detail:
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Created Date: 2007-11-28 Completed Date: 2008-04-16 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8500858 Medline TA: Diabet Med Country: England |
Other Details:
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Languages: eng Pagination: 1381-5 Citation Subset: IM |
Affiliation:
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Steno Diabetes Center, Gentofte, Denmark. ansa@steno.dk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Cohort Studies Diabetes Mellitus, Type 1 / blood*, mortality Diabetic Nephropathies / blood* Female Humans Male Middle Aged Predictive Value of Tests Pregnancy-Associated Plasma Protein-A / analysis* |
| Chemical | |
Reg. No./Substance:
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EC 3.4.24.-/Pregnancy-Associated Plasma Protein-A |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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