J Korean Med Sci.  2013 Feb;28(2):252-260. 10.3346/jkms.2013.28.2.252.

Microalbuminuria is Independently Associated with Arterial Stiffness and Vascular Inflammation but not with Carotid Intima-Media Thickness in Patients with Newly Diagnosed Type 2 Diabetes or Essential Hypertension

• Shin DI
• Seung KB
• Yoon HE
• Hwang BH
• Seo SM
• Shin SJ
• Kim PJ
• Chang K
• Baek SH

• KMID: 1429192
• DOI: http://doi.org/10.3346/jkms.2013.28.2.252

Abstract

The association between microalbuminuria (MAU) and the indices of macrovascular complication in patients with newly diagnosed type 2 diabetes (D) or essential hypertension (H) was evaluated. Total 446 patients were classified into four groups according to the urinary albumin-to-creatinine ratio: MAU-D (n = 104), normoalbuminuria (NAU)-D (n = 114), MAU-H (n = 116), and NAU-H (n = 112). The indices of macrovascular complication including arterial stiffness evaluated by pulse-wave-velocity (PWV), carotid intima-media thickness (IMT), and vascular inflammation marked by high-sensitivity C-reactive protein (hsCRP) were assessed. PWV, IMT, and hsCRP were higher in patients with MAU than in those with NAU in both diabetes and hypertension groups. In both MAU-D and MAU-H groups, PWV and hsCRP levels were positively correlated with MAU level (MAU-D: r = 0.47, 0.41, MAU-H: r = 0.36, 0.62, respectively, P < 0.05). Additionally, PWV and hsCRP were independent factors predicting MAU (diabetes group: OR 1.85, 1.54, hypertension group: OR 1.38, 1.51, respectively, P < 0.001), but not IMT. MAU is independently associated with arterial stiffness and vascular inflammation but not with IMT in patients with newly diagnosed type 2 diabetes or essential hypertension, which emphasizes the importance of proactive clinical investigations for atherosclerotic complications in patients with MAU, even in newly diagnosed diabetes or hypertension.

Keyword

Albuminuria; Vascular Stiffness; Carotid Intima-Media Thickness; Inflammation

MeSH Terms

Albuminuria
Area Under Curve
C-Reactive Protein/analysis
Cardiovascular Diseases/etiology
Carotid Intima-Media Thickness
Creatinine/urine
Diabetes Mellitus, Type 2/complications/*diagnosis/physiopathology
Female
Humans
Hypertension/complications/*diagnosis/physiopathology
Logistic Models
Male
Middle Aged
Multivariate Analysis
Odds Ratio
Risk Factors
Vascular Stiffness
Creatinine
C-Reactive Protein

Figure

• 

  Fig. 1 Correlations between the level of MAU and the levels of PWV and hsCRP. In both MAU-D (A, B) and MAU-H (C, D) groups, the MAU level (Log ACR) was positively correlated with the levels of PWV and hsCRP. MAU-D, diabetes with microalbuminuria; MAU-H, hypertension with microalbuminuria; ACR, albumin-to-creatinine ratio; PWV, brachial-ankle pulse wave velocity; hsCRP, high-sensitivity C-reactive protein.

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