OBJECTIVE Haptoglobin is an acute-phase reactant with pleiotropic functions. We aimed to study whether urine haptoglobin may predict risk of mortality in people with type 2 diabetes. RESEARCH DESIGN AND METHODS We employed a transethnic approach with a cohort of Asian origin (Singapore) (N = 2,061) and a cohort of European origin (France) (N = 1,438) included in the study. We used survival analyses to study the association of urine haptoglobin with risk of all-cause and cause-specific mortality. RESULTS A total of 365 and 525 deaths were registered in the Singapore cohort (median follow-up 7.5 years [interquartile range 3.5-12.8]) and French SURDIAGENE cohort (median follow-up 6.8 years [interquartile range 4.3-10.5], respectively. Singapore participants with urine haptoglobin in quartiles 2 to 4 had higher risk for all-cause mortality compared with quartile 1 (unadjusted hazard ratio [HR] 1.47 [95% CI 1.02-2.11], 2.28 [1.62-3.21], and 4.64 [3.39-6.35], respectively). The association remained significant in quartile 4 after multiple adjustments (1.68 [1.15-2.45]). Similarly, participants in the French cohort with haptoglobin in quartile 4 had significantly higher hazards for all-cause mortality compared with quartile 1 (unadjusted HR 2.67 [2.09-3.42] and adjusted HR 1.49 [1.14-1.96]). In both cohorts, participants in quartile 4 had a higher risk of mortality attributable to cardiovascular disease and infection but not malignant tumor. CONCLUSIONS Urine haptoglobin predicts risk of mortality independent of traditional risk factors, suggesting that it may potentially be a novel biomarker for risk of mortality in patients with type 2 diabetes.

中文翻译：

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尿中肝珠蛋白与2型糖尿病患者全因和特定病因风险的关联：跨种族协作研究。

目的肝珠蛋白是一种具有多效功能的急性期反应物。我们旨在研究尿触珠蛋白是否可以预测2型糖尿病患者的死亡风险。研究设计和方法我们采用跨种族方法，将亚洲血统（新加坡）（N = 2,061）和欧洲血统（法国）（N = 1,438）纳入研究。我们使用生存分析来研究尿触珠蛋白与全因和特定原因致死风险之间的关系。结果在新加坡队列（中位随访时间为7.5年[四分位间距3.5-12.8]）和法国SURDIAGENE队列（中位随访时间为6.8年[四分位间距4.3-10.5]）中，分别有365例和525例死亡。与四分位数1相比，在四分位数2至4中有尿液触珠蛋白的新加坡参与者的全因死亡率更高（未调整风险比[HR] 1.47 [95％CI 1.02-2.11]，2.28 [1.62-3.21]和4.64 [3.39] -6.35]。经过多次调整后，该关联在四分位数4中仍然很显着（1.68 [1.15-2.45]）。同样，与四分位数1相比，法国人群中触珠蛋白在四分位数中的参与者对全因死亡率具有显着更高的危险（未经调整的HR 2.67 [2.09-3.42]和经过调整的HR 1.49 [1.14-1.96]）。在这两个队列中，四分位数4的参与者死于心血管疾病和感染的风险较高，但不是恶性肿瘤。结论尿高蛋白珠蛋白可预测死亡风险，而不受传统风险因素的影响，