RAISED SERUM SIALIC-ACID CONCENTRATION IN NIDDM PATIENTS WITH AND WITHOUT DIABETIC NEPHROPATHY

OBJECTIVE - Raised serum sialic acid concentration is a strong predict or of cardiovascular mortality in the general while population. A prog ressive increase in cardiovascular morbidity and mortality takes place in relation to increasing albuminuria in NIDDM patients. Therefore, w e investigated the potential association between serum sialic acid and micro- and macroangiopathy in NIDDM patients. RESEARCH DESIGN AND MET HODS - We studied a prevalence cohort of all white NIDDM patients <76 years of age attending a diabetic clinic during 1 year. Of the patient s, 319 had normoalbuminuria, 148 had microalbuminuria, and 75 had macr oalbuminuria (diabetic nephropathy was in 47 of 75 patients); 66 nondi abetic age- and sex-matched subjects acted as a control group. Blood s amples were taken for measurements of sialic acid, lipids, creatinine, and HbA(1c). Retinopathy was assessed by funduscopy. The prevalence o f cardiovascular disease was based on Minnesota-coded electrocardiogra ms and the World Health Organization cardiovascular questionnaire. RES ULTS - A progressive raise in serum sialic acid was demonstrated with an Increasing urinary albumin excretion rate: [median (range)] 2.02 (1 .55-2.63); 2.42 (1.47-6.48); 2.67 (1.57-5.86), and 2.95 (1.52-7.86) mm ol/l in nondiabetic subjects, NIDDM patients with normoalbuminuria, mi croalbuminuria, and diabetic nephropathy, respectively (P < 0.05 or le ss for differences between groups). Multiple linear regression analysi s showed that serum cholesterol concentration, serum HDL cholesterol c oncentration, BMI, albuminuria, smoking, and cardiovascular disease co rrelate independently with logarithmic (10) serum sialic acid concentr ation. CONCLUSIONS - Our study revealed a progressive raise in serum s ialic acid with increasing urinary albumin excretion rate in NIDDM pat ients. Furthermore, several modifiable cardiovascular risk factors wer e associated with serum sialic acid.