4B.10: 24 HOUR URINE FREE @entity701 TO XXXX RATIO IS A NOVEL BIOMARKER FOR INCREASED LEFT VENTRICULAR MASS IN DIABETIC HYPERTENSIVES.

@entity1 @entity821 @entity1369 @entity101 @entity6 @entity7774 @entity14128 @entity164 @entity701 @entity1011 @entity65
OBJECTIVE: Renal 11 beta @entity14128 dehydrogenase @entity164 2 (11BHSD2) is a key molecular player in the renin- angiotensin- @entity1369 system (RAAS). We hypothesize that decreased renal 11BHSD2 activity, as measured by increased urinary free @entity701 to @entity821 (UFF/UFE) ratio using gas chromatography-mass spectrometry (GCMS), may be an important biomarker in identifying @entity6 @entity1 with increased left ventricular mass. DESIGN AND METHOD: We studied insulin-naive male @entity1 with @entity164 2 @entity6 and stage 1 @entity101 (blood pressure of 140-160/90-100 mmHg) in this study. 24-hour urine was collected and UFF/UFE ratio was determined using GCMS. All @entity1 underwent 2D-echocardiogram (2DE) for measurement of left ventricular mass index (LVMI). RESULTS: A total of 43 @entity6 male @entity1 with @entity101 were evaluated in this study. As per current @entity101 guidelines, all subjects were already taking either an @entity7774 converting enzyme inhibitor (ACE) or angiotensin receptor blocker (ARB) for their @entity101 control. The mean 24 hour UFF/UFE ratio was 0.77+/- 0.05 (interquartile range 0.52 to 1.00), with higher UFF/UFE ratios reflecting lower renal 11BHSD2 activity. Higher UFF/UFE ratio correlated with higher LVMI (r=0.46, p=0.003). Among the subjects in the highest quartile (UFF/UFE ratio > 1.00), the left ventricular mass index was significantly higher (113.8g/m2 vs 89.1g/m2, p=0.03; difference between means 23.7+/- 9.8g/m2) when compared to the rest of the cohort. This association was independent of age, blood pressure, duration of @entity6 , medications, glycated hemoglobin (HBA1C), body mass index (BMI), ethnicity or serum @entity1011 . CONCLUSIONS: In diabetics with stage 1 @entity101 , a 24 hour urine free @entity701 to @entity821 ratio >1.00 as measured by gas chromatography-mass spectrometry, independently identifies @entity1 with a significantly higher left ventricular mass, a subset of @entity1 known to be at a higher risk of developing @entity65 .
