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Relationship between albuminuria and cardiovascular disease in Type 2 diabetes

Barry I Freedman1, Carl D Langefeld, Kurt K Lohman

  • 1Department of Internal Medicine/Nephrology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157-1053, USA. bfreedma@wfubmc.edu

Journal of the American Society of Nephrology : JASN
|May 6, 2005
PubMed

Insights

Albuminuria (urine albumin-to-creatinine ratio) is linked to more calcified plaque in coronary and carotid arteries for type 2 diabetes patients. This finding highlights a connection between kidney health and cardiovascular disease risk in this population.

Area of Science:

  • Cardiology
  • Nephrology
  • Diabetology

Background:

  • Impaired renal function and albuminuria are common in type 2 diabetes.
  • These conditions are known predictors of atherosclerotic cardiovascular events.
  • The relationship between albuminuria and calcified plaque was previously unknown.

Purpose of the Study:

  • To investigate the association between albuminuria and measures of calcified atherosclerotic plaque.
  • To determine if albuminuria correlates with coronary and carotid artery calcification in individuals with type 2 diabetes.

Main Methods:

  • 588 white participants with type 2 diabetes were studied.
  • Coronary and carotid artery calcified plaque were measured using computed tomography.
  • Common carotid artery intima-medial thickness (IMT) was measured using ultrasonography.
  • Urine albumin-to-creatinine ratio (ACR) and other risk factors were analyzed.
  • Generalized estimating equations were used to test for associations.

Main Results:

  • Albuminuria (ACR) showed a strong positive association with coronary artery calcium.
  • Albuminuria (ACR) was also strongly associated with carotid artery calcium.
  • These associations remained significant after adjusting for major cardiovascular risk factors.

Conclusions:

  • Albuminuria is strongly associated with calcified plaque in both coronary and carotid arteries.
  • This association exists in white individuals with type 2 diabetes, even with relatively preserved kidney function.
  • The findings suggest albuminuria is a significant marker for atherosclerosis in type 2 diabetes.

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