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

A. Heraclides, T. M. Jensen, S. S. Rasmussen, J. Eugen-Olsen, S. B. Haugaard, K. Borch-Johnsen, A. Sandbæk, T. Lauritzen, D. R. Witte

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Aims/hypothesis: Recent evidence links the soluble urokinase plasminogen activator receptor (suPAR), a stable biomarker of systemic immune activation, to several chronic diseases, including type 2 diabetes. suPAR is also associated with adiposity and smoking. We hypothesised that this biomarker would be linked to incident type 2 diabetes in individuals with impaired glucose regulation and that this association would be modified by smoking and body weight status. Methods: The study included 1,933 participants with impaired glucose regulation, who were drawn from the Danish arm of the Anglo-Danish-Dutch Study of Intensive Treatment in People with Screen-Detected Diabetes in Primary Care (ADDITION) and for whom data on suPAR, BMI and smoking were available. Logistic regression analysis was used to estimate the odds for incident type 2 diabetes per twofold increase in suPAR levels. Interactions between both smoking and body weight status and suPAR were tested. Results: During a 3-year follow-up (599 incident diabetes cases), there was a 48% overall increase in the odds of developing type 2 diabetes per twofold increase in suPAR (p = 0.006). This association was modified by body weight status in overweight, but not in obese individuals (OR 2.36, 95% CI 1.48, 3.76 in overweight group), and by smoking status (OR 2.05, 95% CI 1.20, 3.51 in non-smokers). After adjustment for other diabetes risk factors, the association between suPAR and type 2 diabetes was attenuated in the whole sample and among non-smokers, but remained robust among overweight participants. Conclusions/interpretation: suPAR may be a good novel biomarker for systemic sub-clinical inflammation and immune activation linked to incident type 2 diabetes risk in overweight individuals and non-smokers. The observed interactions with adiposity and smoking should be investigated further.

Original languageEnglish
Pages (from-to)1542-1546
Number of pages5
JournalDiabetologia
Volume56
Issue number7
DOIs
Publication statusPublished - Jul 2013

Keywords

  • BMI
  • Body mass index
  • Impaired glucose regulation
  • Incident type 2 diabetes
  • Smoking
  • Soluble urokinase plasminogen activator receptor
  • Sub-clinical inflammation
  • suPAR

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