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

J Korean Med Sci. 2013 Feb;28(2):252-60. doi: 10.3346/jkms.2013.28.2.252. Epub 2013 Jan 29.

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.

Keywords: Albuminuria; Carotid Intima-Media Thickness; Inflammation; Vascular Stiffness.

MeSH terms

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

Substances

  • C-Reactive Protein
  • Creatinine