Endocan and albuminuria in type 2 diabetes mellitus

Abstract

Background: Endocan is a newly identified proteoglycan released from endothelium, stimulating angiogenesis and when increased, indicates endothelial activation (inflammation). Our aim was to examine the association between serum endocan levels and urine albumin-creatinine ratio (UACR). Method: One hundred and thirty-seven patients with type 2 diabetes mellitus and normal serum creatinine who had no co-morbidities other than hypertension, diabetic nephropathy, retinopathy, or neuropathy were divided into normoalbuminuria (G1), microalbuminuria (G2), and macroalbuminuria (G3) groups and compared cross-sectionally regarding serum endocan levels. Result: There were 55, 47, and 35 patients in G1, G2, and G3, respectively. The groups were comparable in terms of gender, age, duration of diabetes, diabetic neuropathy/retinopathy, fasting glucose, HbA1c, serum creatinine level, and eGFR. Patients in G3 had significantly higher blood pressure but lower serum albumin and endocan levels. UACR showed a negative bivariate correlation with serum endocan levels (r ¼ À.282, p ¼ .001). There was bivariate positive correlation between endocan and systolic blood pressure (r¼.185, p ¼ .030). In linear regression analysis, UACR was negatively correlated with endocan while positively correlated with systolic blood pressure, duration of diabetes, and platelet distribution width. Conclusion: Patients with macroalbuminuria had lower endocan levels, and increasing UACR was associated with decreasing serum endocan levels. Despite the occurrence of angiogenesis and glomerular hypertrophy in the early phase of diabetic nephropathy, ensuing significant renal injury over time may reduce the expression of endocan. Serum endocan levels may represent a novel marker for nephropathy progression.

Association of Endocan, Ischemia-Modified Albumin, and hsCRP Levels With Endothelial Dysfunction in Type 2 Diabetes Mellitus

“…38 In another study, a negative correlation was detected between endocan level and urinary albumin excretion. 39 In a study conducted by Arman and colleagues in patients with T2DM, a positive correlation was found between endocan levels and urinary albumin excretion, similar to our study. 28 Since several studies have shown that there is a positive association between proteinuria and endothelial dysfunction, we expect a positive correlation between urinary protein and albumin excretion and endocan levels.…”

Proteoglycans in Obesity-Associated Metabolic Dysfunction and Meta-Inflammation

“…In psoriasis patients, a common chronic inflammatory skin disease, elevated endocan levels correlated with enhanced mean carotid artery intima-media thickness, BMI, and TNF levels (133). However, conflicting data in T2D patients indicated that using endocan as a prognostic biomarker is a much more sophisticated endeavor, as plasma endocan concentrations were significantly reduced and correlated inversely with waist circumference and CRP levels, a marker for systemic inflammation (126,134,135). In the same T2D patient population endocan serum levels associated with increased urinary albumin to creatinine ratios, suggesting a role for endocan in the progression of kidney injury in obesitymediated diabetes (135).…”

“…However, conflicting data in T2D patients indicated that using endocan as a prognostic biomarker is a much more sophisticated endeavor, as plasma endocan concentrations were significantly reduced and correlated inversely with waist circumference and CRP levels, a marker for systemic inflammation (126,134,135). In the same T2D patient population endocan serum levels associated with increased urinary albumin to creatinine ratios, suggesting a role for endocan in the progression of kidney injury in obesitymediated diabetes (135). Evaluation of a DKD mouse model confirmed that ESM1 expression decreased in glomeruli with an ensuing reduction in endocan plasma levels and increased urinary concentration (136).…”

Serum Endocan Levels Associated with Hypertension and Loss of Renal Function in Pediatric Patients after Two Years from Renal Transplant

“…There is strong evidence to support its role in several chronic diseases and that suggests that it is an important biomarker of endothelial function [13, 18, 19]. The findings from a recent study showed that patients with type 2 diabetes who had microalbuminuria had lower endocan levels [23], and the investigators suggested that higher levels of endocan may be present in the early phase of diabetic nephropathy and that the levels of endocan decline as the disease progresses [23]. To date, few studies have evaluated the role of the endocan levels in RT patients.…”