Correlation of soluble urokinase plasminogen activator receptor (suPAR) with HbA1c in predicting vascular complications in young adults - A cross sectional study.

Background: suPAR is a soluble form of a membrane protein "Urokinase-type plasminogen activator receptor" which is connected by glycosyl-phosphatidylinositol present in a large number of "immunologically active cells". A number of clinical diseases have shown elevated serum suPAR levels, which increase with immune system activation. This study aimed to evaluate serum suPAR levels, serum creatinine, serum lipid profile and eGFR in patients with different levels of glycaemic control, and correlate suPAR concentration with study parameters across various groups of HbA1c.

Methods: A cross-sectional study was done in the blood samples from 88 subjects in the age group of 25-40 years. These subjects were categorised into 4 groups based on their HbA1c levels namely prediabetes (Group 1). good glycemic control (Group 2), fair glycemic control (Group3), and normal glycemic control (Group 4). Serum creatinine was estimated by autoanalyzer. HbA1c was estimated using BIORAD D10 and estimation of total cholesterol, triglycerides, and HDL was done by semi-autoanalyzer. suPAR levels were estimated by ELISA. LDL was calculated from the Friedewald's equation and eGFR was calculated from the MDRD equation. Pearson's correlation analysis was done to find out the association of suPAR concentrations with the biochemical parameters in various groups.

Results: Serum triglycerides, was highly significantly increased in good and fairly controlled diabetics (Groups 2 and 3)when compared to control group(Group 4). No statistical significance was observed between any two independent groups when suPAR was correlated with HbA1c. A negative correlation of suPAR with HDL and suPAR with eGFR in controls, prediabetic and fairly or good controlled diabetics was observed but not to the level of significance.

Conclusion: Our study does not establish a correlation of suPAR in diabetic population with varying degrees of glycaemic control. It may also reflect that suPAR is not useful as a marker of inflammation in younger diabetics in particular.