2008, Number 1
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Rev Invest Clin 2008; 60 (1)
Factors associated with microalbuminuria in non-hypertensive type-2 diabetes patients
López-Arce G, Espinoza-Peralta D, Hernández-Alarcón A, Arce-Salinas CA
Language: Spanish
References: 45
Page: 4-10
PDF size: 67.65 Kb.
ABSTRACT
Introduction. Microalbuminuria is a well known risk factor for renal damage and for cardiovascular disease in type-2 diabetic patients.
Objective. To evaluate anthropometric, laboratory, and diet factors related to the presence of microalbuminuria in non-hypertensive type 2 diabetic subjects.
Material and methods. We carry-out an assessment of a group of nonhypertensive diabetic patients with or without microalbuminuria. Some anthropometric measures, physical fitness, tobacco and
alcohol consumption, creatinine clearance, HbA
1c, lipid profile, the mean fast serum glucose levels in last two years, 24 h urine protein, and caloric intake were all measured.
Results. From 86
included patients, 19 had microalbuminuria; it was related with the length of diabetes mellitus duration (114 ± 55
vs. 84 ± 67 months;
p = 0.03), higher HbA
1c level (8.9
vs. 7.1%;
p = 0.001), and lower HDL-cholesterol levels (37.7 ± 11
vs. 42.9 ± 12 mg/dL;
p = 0.03). In the multivariate analysis HbA
1c level, and mean fast
glucose remained significant.
Conclusions. In non-hypertensive diabetic subjects, poor glucose control, and longer disease duration were both related with microalbuminuria. Moreover, caloric intake, exercise, tobacco or alcohol consumption, or BMI did not show association with microalbuminuria.
REFERENCES
Zimmet P, Alberti KG, Shawn J. Global and societal implications of the diabetes epidemic. Nature 2001; 414: 782-7.
http://www.usrds.org/adr.htm (en linea).
Barsoum R. Chronic kidney disease in the developing world. N Engl J Med 2006; 354: 997-9.
Ritz E, Orth SR. Nephropathy in patients with type 2 diabetes mellitus. N Engl J Med 1999; 341: 1127-33.
Deferrari G, Repetto M, Calvi C, et al. Diabetic nephropathy: from micro- to macroalbuminuria. Nephrol Dial Transplant 1998; 13: 11-5.
Walls J. Relationship between proteinuria and progressive renal disease. Am J Kidney Dis 2001; 37(Suppl. 2): S13-S6.
Meigs JB, D’Agostino RB, Nathan DM, et al. Longitudinal association of glycemia and microalbuminuria. The Framingham Offspring Study. Diabetes Care 2002; 25: 977-83.
Pedrinelli R, Giampietro O, Carmassi F, et al. Microalbuminuria and endothelial dysfunction in essential hypertension. Lancet 1994; 344: 14-8.
Murray E, Vito C. Pleiotropic effects of 3-hidroxy-3-methylglutaryl coenzyme a reductase inhibitors on renal function. Am J Kidney Dis 2005; 45: 2-14.
Stern MP. Diabetes and cardiovascular disease: the “common soil” hypothesis. Diabetes 1995; 44: 369-74.
Jiménez CA, Rivera MD, Hernández AM, et al. Microalbuminuria as a predictor of myocardial infarction in a Mexican population: The Mexico City Diabetes Study. Kidney International 2005; 68(Suppl. 97): S34-9.
Rosas M, Attie F, Pastelin G, et al. Prevalance of proteinuria in Mexico: A conjunctive consolidation approach with other cardiovascular risk factors: The Mexican Health Survey 2000. Kidney International 2005; 68(Suppl. 97): S112-9.
Cueto-Manzano AM, Cortés-Sanabria LC, Martínez-Ramírez R, et al. Detection of early nephropathy in Mexican patients with type 2 diabetes mellitus. Kidney International 2005; 68(Suppl. 97): S40-5.
Aguilar-Salinas C, Velázquez MO, Gómez-Pérez FJ, et al. Characteristics of patients with type 2 diabetes in Mexico. Diabetes Care 2003; 26: 2021-6.
Villalpando GC, Stern MP, Arredondo PB, et al. Nephropathy in low income diabetics: the Mexico City Diabetes Study. Arch Med Res 1996; 27: 367-72.
Wrone E, Carnethon MR, Palaniappan L, et al. Association of dietary protein intake and microalbuminuria in healthy adults: Third National Health and Nutrition Examination Survey. Am J Kidney Dis 2003; 41: 580-7.
Orchard TJ, Chang YF, Ferrell RE, et al. Nephropathy in type 1 diabetes: a manifestation of insulin resistance and multiple genetic susceptibilities? Further evidence from the Pittsburgh Epidemiology of Diabetes Complication Study. Kidney Int 2002; 62: 963-70.
Mykkanen L, Zaccaro DJ, Wagenknecht LE, et al. Microalbuminuria is associated with insulin resistance in non-diabetic subjects: the insulin resistance atherosclerosis study. Diabetes 1998; 47: 793-800.
Mogensen CE, Viberti G, Halimi S, et al. Effect of Low-Dose Perindopril/Indapamide on Albuminuria in Diabetes. Hypertension 2003; 41: 1063-71.
Douglas K, O’Malley PG, Jackson JL. Meta-Analysis: The Effect of Statins on Albuminuria. Ann Intern Med 2006; 145: 117-24.
American Diabetes Association. Standards of Medical Care in Diabetes. Diabetes Care 2006; 29(Suppl. 1): S4-42.
Chobanian AV, Bakris GL, Black HR, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: The JNC 7 Report. JAMA 2003; 289: 2560-71.
Departamento de Ciencia y Tecnología de Alimentos, Departamento de Informática en Investigación. Tablas de composición de alimentos mexicanos. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. México, D.F. 1998 (Disponible en: http://www.innsz.mx/alimentos/cd.html).
Stevens LA, Coresh J, Greene T, et al. Assessing kidney function- measured and estimated glomerular filtration rate. N Engl J Med 2006; 354: 2473-83.
Cooper ME, Jandeleit-Dahm K, Thomas MC. Targets to retard the progression of diabetic nephropathy. Kidney Int 2005; 68: 1439-45.
The Diabetes Control and Complications (DCCT) Research Group. Effect of intensive therapy on the development and progression of diabetic nephropathy in the Diabetes Control and Complications Trial. Kidney Int 1995; 47: 1703-20.
Ruggenenti P, Remuzzi G. Microalbuminuria, time to abandon. Kidney Int 2006; 70: 1214-22.
Manaviat MR, Afkhami M, Shoja MR. Retinopathy and microalbuminuria in type II diabetic patients. BMC Ophthalmol 2004; 4-9.
Deferrari G. Treatment of diabetic nephropathy in its early stages. Diabetes Metabol Rev 1997; 13: 51-61.
Colhoun HM, Lee ET, Bennett PH, et al. Risk factors for renal failure: The WHO Multinational Study of Vascular Disease in Diabetes. Diabetologia 2001; 44(Suppl. 2): S46-S53.
Hsu C, McCulloch CE, Iribarren C, et al. Body mass index and risk for end-stage renal disease. Ann Intern Med 2006; 144: 21-8.
Zandbergen AAM, Sijbrands J, et al. Normotensive Women with type 2 Diabetes and microalbuminuria are at high risk for macrovascular disease. Diabetes Care 2006; 29: 1851-5.
Kohler K, McClellan WM, Ziemer DC, et al. Risk factors for microalbuminuria in black Americans with newly diagnosed type 2 diabetes. Am J Kidney Dis 2000; 36: 903-13.
Nosadini R, Velussi M, Brocco E, et al. Course of renal function in type 2 diabetic patients with abnormalities of albumin excretion rate. Diabetes 2000; 49: 476-84.
Lassila M, Seah KK, Allen TJ, et al. Accelerated nephropathy in diabetic apolipoprotein E- knockout mouse: Role of advanced glycation end products. J Am Soc Nephrol 2004; 15: 2125-38.
Eto M, Sato M, Okada M, et al. Apolipoprotein E genetic polymorphism, remnant lipoproteins, and nephropathy in type 2 diabetic patients. Am J Kidney Dis 2002; 40: 243-51.
Molitch ME, Rupp D, Carnethon M. Higher levels of HDLcholesterol are associated with a decreased likelihood of albuminuria in patients with long-standing type 1 diabetes. Diabetes Care 2006; 29: 78-82.
Krolewski AS, Warram JH, Christlieb AR. Hypercholesterolemia: a determinant of renal function loss and deaths in IDDM patients with nephropathy. Kidney Int 1994; (Suppl. 45): S125-31.
Domínguez JH, Tang N, Xu W, et al. Studies of renal injury III: Lipid-induced nephropathy in type II diabetes. Kidney Int 2000; 57: 92-104.
Nosadini R, Tonolo G. Blood glucose and lipid control as risk factors in the progression of renal damage in type 2 diabetes. J Nephrol 2003; 16(Suppl.): S42-47.
Geluk C, Asselbergs F, Hillege H. Impact of statins in microalbuminuric subjects with the metabolic syndrome: a substudy of the PREVEND intervention trial. Eur Heart J 2005; 26: 1249-51.
Hommel E, Andersen P, Gall MA, et al. Plasma lipoproteins and renal function during simvastatin treatment in diabetic nephropathy. Diabetologia 1992; 35: 447-51.
Lintott CJ, Scott RS, Bremer JM, et al. Fluvastatin for dyslipoproteinemia, with or without concomitant chronic renal insufficiency. Am J Cardiol 1995; 76: 97A-101A.
Nielsen S, Schmitz O, Moller N. Renal function and insulin sensitivity during simvastatin treatment in type 2 (non-insulindependent) diabetic patients with microalbuminuria. Diabetologia 1993; 36: 1079-86.
Rossing P. Prediction, progression and prevention of diabetic nephropathy. The Minkowsky lecture 2005. Diabetologia 2006; 49: 11-19.