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Clinical correlates with microalbuminuria in non‐insulin dependent diabetes: Preliminary results of the appropriate blood pressure control in diabetes trial
Author(s) -
SCHRIER ROBERT W,
ESTACIO RAYMOND O
Publication year - 1996
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/j.1440-1797.1996.tb00141.x
Subject(s) - medicine , microalbuminuria , albuminuria , diabetes mellitus , body mass index , odds ratio , retinopathy , univariate analysis , endocrinology , diabetic retinopathy , multivariate analysis
Summary: Clinical correlates associated with urinary albumin excretion (UAE) in non‐insulin dependent diabetes (NIDDM) are less well known than in insulin dependent diabetes (IDDM). We therefore performed a cross sectional study examining the relationships of clinical risk factors and diabetic complications with UAE in 950 NIDDM patients. the UAE status was classified into the following categories: (i) no albuminuria (<20 μmg/min), (ii) microalbuminuria (20–200 μg/min); and (iii) overt albuminuria (>200 μg/min). Univariate and miltivariate analyses were initially performed evaluating the associations between clinical risk factors and UAE. Univariate and multivariate analyses were then performed examining the relationships between UAE and the diabetic complications (retinopathy, neuropathy and cardiovascular disease). Using multivariate logistic regression analyses controlling for diabetes duration, glycosylated haemoglobin, gender and race, the most significant predictors of microalbuminuria and overt albuminuria were systolic hypertension, increased body mass index (BMI), decreased high‐density lipoprotein (HDL) cholesterol, insulin use and smoking pack years. Univariate and multivariate analyses evaluating the associations between UAE and diabetic complications revealed that UAE was a strong predictor of retinopathy (odds ratio [OR]=1.31:95% confidence interval [CI]=1.05,1.66), neuropathy (OR=1.47; CI=1.19,19.83), and cardiovascular diseases (OR=1.28; CI=1.05,1.52). Thus, in the present study increases in UAE were associated with retinopathy, neuropathy and cardiovascular disease. Urinary albumin excretion may therefore be a marker of diffuse vascular disease in NIDDM. Aggressive treatment of smoking, cholesterol and hypertension may not only diminish UAE but may also play a significant role in decreasing the other NIDDM vascular complications.