The biomarker suPAR and endocrinology

TThe suPAR level is elevated in individuals who develop type 2 diabetes later in life. suPAR is elevated in type 1 diabetes and is strongly associated with the development of diabetes complications

  • Incidence of type 2 diabetes1,2
  • Incidence and duration of type 1 diabetes3
  • Type 1 diabetes complications3-4

In a Danish cohort of healthy individuals, significantly higher suPAR values were found in those who developed type 2 diabetes1. In the group of middle-aged non-smokers, the risk of developing diabetes was significantly higher in individuals with a high suPAR level than those with a low suPAR level. The increased risk remained following adjustment for fasting blood glucose, age, sex, and insulin levels. A similar risk was found in the elderly1.

Similarly, among overweight individuals (BMI 25-30) with impaired glucose tolerance and a high suPAR level, an increased risk of developing diabetes is observed2.

people with type 1 diabetes, suPAR is strongly associated with the development of diabetes complications. In a study published in Diabetes Care (2019), 36 out of 37 patients that developed the end-stage renal disease within the 6-year follow-up period were in the highest suPAR quartile. Patients in the two lowest suPAR quartiles seemed to be protected against developing renal complications3. A low suPAR level was also protective against a decline in GFR ≥30%, cardiovascular disease and mortality3,4.

“suPAR is an early predictive marker for complications in type 1 diabetes … and is a potent risk factor in prediction of cardiovascular and renal diseases”

Viktor Rotbain Curovic,
Dr. MD, Steno Diabetes Center Copenhagen, Denmark
suPAR News Vol. 2, Sept. 2019

1. Haugaard SB, Andersen O, Hansen TW et al. The immune marker soluble urokinase plasminogen activator receptor is associated with new-onset diabetes in non-smoking women and men. Diabet Med. 2012 Apr;29(4):479-487
2. Heraclides A, Jensen TM, SS Rasmussen et al. The pro-inflammatory biomarker soluble urokinase plasminogen activator receptor (suPAR) is associated with incident type 2 diabetes among overweight but not obese individuals with impaired glucose regulation: effect modification by smoking and body weight status. Diabetologia. 2013 Apr 24
3. Theilade S, Lyngbaek S, Hansen TW, et al. Soluble urokinase plasminogen activator receptor levels are elevated and associated with complications in patients with type 1 diabetes. J Intern Med 2015;277
4. Rotbain Curovic V et al, Soluble Urokinase Plasminogen Activator Receptor Predicts Cardiovascular Events, Kidney Function Decline, and Mortality in Patients With Type 1 Diabetes. Diabetes Care. 2019. pii: dc181427.

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