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

Affiliations
  • 1Division of Cardiology, Department of Internal Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, Korea.
  • 2Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea. kbseung@catholic.ac.kr
  • 3Division of Nephrology, Department of Internal Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea, Incheon, Korea.

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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