Plasma HCII activity may help predict early diabetic kidney disease

In patients with diabetes, plasma heparin cofactor II (HCII) activity is inversely associated with glomerular injury and may serve as a biomarker for early-stage diabetic kidney disease (DKD), a new study has found.

Researchers enrolled 310 Japanese diabetes mellitus patients, from whom plasma HCII activity was measured using the appropriate assays. Other biochemical markers assessed included albumin and liver-type fatty acid-binding protein (L-FABP), which were then used to obtain the urine albumin-to-creatinine (uACR) and L-FABP-to-creatinine (uL-FABPCR) ratios.

The average plasma HCII activity in the overall sample was 93.8±17.7 percent and showed significant correlations with serum and plasma markers such as fibrinogen (p<0.001), uACR (p=0.044), and log-transformed uACR (p=0.028).

Multivariate regression analysis found that plasma HCII activity was a significant and independent protective factor against increasing uACR (t, –2.11; p=0.036) and log-transformed uACR (t, –2.76; p=0.006). No such effect was reported for uL-FABPCR (p=0.541). Being male was likewise significantly inversely correlated with uACR and log-transformed uACR, but also with uL-FABPCR.

In contrast, systolic blood pressure, glycated haemoglobin, and creatinine were positively and significantly associated with all three urinary biomarkers.

“The data generated in this study demonstrate that the plasma HCII activity served as a negative clinical factor for albuminuria development in patient with diabetes,” the researchers said. “Measuring the plasma HCII activity might enable the prediction and/or development of glomerular disease in patients with DKD at an early stage.”