{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T15:04:28Z","timestamp":1792508668446,"version":"4.5.0"},"reference-count":41,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,12,13]],"date-time":"2023-12-13T00:00:00Z","timestamp":1702425600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,12,13]],"date-time":"2023-12-13T00:00:00Z","timestamp":1702425600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Cardiovasc Diabetol"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>In the last years, the classical pattern of diabetic kidney disease (DKD) has been partially overcome, because of the uncovering of a new DKD phenotype with significant renal dysfunction without presence of albuminuria: the non-albuminuric DKD (NA-DKD). To date, the cardiovascular risk associated with this phenotype is still debated. We investigated the cardiovascular risk and renal injury profile of NA-DKD subjects in comparison with other DKD phenotypes.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Pulse wave velocity (PWV), intima-media thickness, presence of carotid atherosclerotic plaque, renal resistive index (RRI), and a panel of urinary biomarkers of kidney injury were evaluated in 160 subjects with type 2 diabetes, stratified according to estimated glomerular filtration rate (eGFR) and urinary albumin to creatinine ratio (UACR) into four groups: controls (UACR\u2009&lt;\u200930\u00a0mg\/g and eGFR\u2009\u2265\u200960\u00a0mL\/min\/1.73\u00a0m<jats:sup>2<\/jats:sup>), A-DKD (Albuminuric-DKD, UACR\u2009\u2265\u200930\u00a0mg\/g and eGFR\u2009\u2265\u200960\u00a0mL\/min\/1.73\u00a0m<jats:sup>2<\/jats:sup>), NA-DKD (UACR\u2009&lt;\u200930\u00a0mg\/g and eGFR\u2009&lt;\u200960\u00a0mL\/min\/1.73\u00a0m<jats:sup>2<\/jats:sup>), AL-DKD (Albuminuric and Low eGFR-DKD; UACR\u2009\u2265\u200930\u00a0mg\/g and eGFR\u2009&lt;\u200960\u00a0mL\/min\/1.73\u00a0m<jats:sup>2<\/jats:sup>).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Subjects with NA-DKD showed a higher PWV (11.83\u2009\u00b1\u20093.74\u00a0m\/s vs. 10.24\u2009\u00b1\u20092.67\u00a0m\/s, <jats:italic>P<\/jats:italic>\u2009=\u20090.045), RRI (0.76\u2009\u00b1\u20090.11 vs. 0.71\u2009\u00b1\u20090.09,<jats:italic> P<\/jats:italic>\u2009=\u20090.04), and prevalence of carotid atherosclerotic plaque (59% vs. 31%, <jats:italic>P<\/jats:italic>\u2009=\u20090.009) compared with controls. These characteristics were similar to those of subjects with AL-DKD, whereas the profile of A-DKD subjects was closer to controls. After multiple regression analyses, we found that RRI, that is in turn influenced by eGFR (\u03b2\u2009=\u2009\u2212\u00a00.01, <jats:italic>P<\/jats:italic>\u2009=\u20090.01), was one of the major determinants of PWV (\u03b2\u2009=\u20099.4, <jats:italic>P<\/jats:italic>\u2009=\u20090.02). Urinary TreFoil Factor 3, a marker of tubular damage, was higher in NA-DKD subjects vs. controls (1533.14\u2009\u00b1\u2009878.31\u00a0ng\/mL vs. 1253.84\u2009\u00b1\u2009682.17\u00a0ng\/mL, <jats:italic>P<\/jats:italic>\u2009=\u20090.047). Furthermore, after multiple regression analyses, we found that urinary osteopontin was independently associated with PWV (\u03b2\u2009=\u20092.6, <jats:italic>P<\/jats:italic>\u2009=\u20090.049) and RRI (\u03b2\u2009=\u20090.09, <jats:italic>P<\/jats:italic>\u2009=\u20090.006).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Our data showed a worse cardiovascular and renal injury profile in NA-DKD subjects. This finding emphasizes the central role of eGFR in the definition of cardiovascular risk profile of diabetic subjects together with albuminuria.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12933-023-02065-2","type":"journal-article","created":{"date-parts":[[2023,12,13]],"date-time":"2023-12-13T16:02:37Z","timestamp":1702483357000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":44,"title":["Cardiovascular risk and renal injury profile in subjects with type 2 diabetes and non-albuminuric diabetic kidney disease"],"prefix":"10.1186","volume":"22","author":[{"given":"Maurizio","family":"Di Marco","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina","family":"Scilletta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicoletta","family":"Miano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Marrano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annalisa","family":"Natalicchio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Giorgino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Di Mauro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnese","family":"Filippello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Scamporrino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Tribulato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giosiana","family":"Bosco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Di Giacomo Barbagallo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Scicali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agostino","family":"Milluzzo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Ballir\u00f2","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia","family":"Frittitta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Castellino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Purrello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"Piro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonino","family":"Di Pino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,12,13]]},"reference":[{"key":"2065_CR1","doi-asserted-by":"publisher","first-page":"2032","DOI":"10.2215\/CJN.11491116","volume":"12","author":"RZ Alicic","year":"2017","unstructured":"Alicic RZ, Rooney MT, Tuttle KR. 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