Urinary pteridines as a discriminator of atherosclerotic risk in patients with diabetes

Abstract

Background and aimsWe have recently proposed urinary pteridine level as a useful biomarker of oxidative stress in a general population. However, the significance of urinary pteridines in patients with diabetes is unknown. MethodsThe relationships of the level of urinary pteridine derivatives with d-dimer, ankle-brachial pressure index (ABI), and known cardiovascular risk factors were investigated in patients with type 2 diabetes. ResultsUrinary pteridine level showed significant positive correlations with urinary15-isoprostane F2t, female gender, history of smoking and d-dimer and significant inverse correlations with history of alcohol drinking, body mass index (BMI) and ABI. ABI was significantly lower and d-dimer was significantly higher in the highest tertile group of pteridines than in the lowest tertile group. The odds ratios of the highest vs. lowest tertiles for low ABI and high d-dimer were significantly higher than the reference level. The above relationships of urinary pteridines with ABI and d-dimer were not altered when age, gender, BMI, hemoglobin A1c and history of alcohol drinking were used as explanatory variables in multivariable analyses. History of smoking confounded the relation of pteridines with ABI but not that with d-dimer. However, in logistic regression analysis, the association between pteridines and ABI remained significant with adjustment for history of smoking. ConclusionUrinary pteridine level was associated with d-dimer and ABI, which reflect blood coagulability and arterial flow to the lower extremities, respectively, and is thus thought to be a useful discriminator of thromboatherosclerotic risk in patients with diabetes.