Type 2 Diabetes Risk Predicted by Urine Test
The kynurenine:tryptophan ratio (KTR) found in urine is a strong predictor for incident type 2 diabetes among individuals with coronary artery disease (CAD), according to a recent study.
Previous evidence has indicated that the tryptophan metabolite kynurenine has strong immune modulatory and vasoactive properties. Although existing experimental data has implicated kynurenine in comorbidities related to obesity, data from epidemiological studies are sparse.
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For their study, the researchers evaluated 2519 participants with CAD without diabetes. Mean age was 61.3 years, mean body mass index (BMI) was 25.9 kg/m2, and median HbA1c was 5.6%. A total of 73.1% of participants were men. Follow-up lasted a median of 7.6 years.
The potential relationships of plasma and urine KTR with new-onset type 2 diabetes were analyzed via multivariate Cox regression analyses.
Over the course of follow-up, 173 (6.9%) cases of new-onset type 2 diabetes were reported. Results indicated that urine KTR was strongly associated with the risk for type 2 diabetes, while plasma KTR was not significantly related to this risk. The researchers noted that the hazard ratio for quartile 4 in the age- and sex-adjusted and multivariate models was 2.59, compared with 2.35 in quartile 1.
“Urine KTR is a strong predictor of incident type 2 diabetes in individuals with CAD,” the researchers concluded. “Potential clinical implications and possible pathogenic roles of renal kynurenine excretion in type 2 diabetes development should be further elucidated.”
—Christina Vogt
Reference:
Rebnord EW, Strand E, Midttun Ø, et al. The kynurenine:tryptophan ratio as a predictor of incident type 2 diabetes mellitus in individuals with coronary artery disease. Diabetologia. 2017;60(9):1712-1721. doi:10.1007/s00125-017-4329-9.