The biomarker suPAR and endocrinology
The suPAR level is elevated in individuals that later develop type 2 diabetes, suPAR is elevated in type 1 diabetes and 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 compared to 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.
In type 1 diabetics, suPAR is strongly associated with development of diabetes complications. In a study published in Diabetes Care (2019), 36 out of 37 patients that developed 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 decline in GFR ≥30%, cardiovascular disease and mortality3,4.
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.