A marker of the likely course of diabetic nephropathy (DN) has been found. An 18-year study has shown that Immunoglobulin M (IgM) is a reliable predictor of cardiovascular complications in DN patients.
Omran Bakoush, MD, PhD, led a team of researchers from Lund University, Sweden, who carried out the research. He said, "To our knowledge, this study is the first to investigate the impact of increased urine IgM excretion on DN disease progression in type 1 diabetic patients. We found that those with increased urinary IgM excretion had a higher mortality from cardiovascular causes, and higher disease progression rate to end-stage renal disease. This association is largely independent of the level of albuminuria".
The researchers followed 139 patients with type 1 diabetes mellitus between 1984 and 2007. Patients with increased urine IgM excretion, measured by ELISA at the beginning of the study, were approximately three times more likely to die or progress to end-stage renal disease. Commenting on these findings, Dr Bakoush said, "These findings may offer a new approach to manage this rapidly increasing patient population. While measurement of albuminuria is routinely used to evaluate and manage patients with diabetes, increased urine IgM excretion would identify more specifically patients at risk for serious cardiovascular complications (death, and renal failure). If increased urine IgM excretion does reflects advanced atherosclerotic vascular disease, clinical trials would be justified to test whether modifying atherosclerotic factors, also decrease mortality and incidence of renal failure in diabetic patients with or without IgM-uria".
- Rafid Tofik, Ole Torffvit, Bengt Rippe and Omran Bakoush. Increased urine IgM excretion predicts cardiovascular events in patients with type 1 diabetes nephropathy. BMC Medicine, (in press)
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