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Vascular risk factors in Japanese non-insulin-dependent diabetic patients with microalbuminuria
T Kodama1, T Tomiyama, T Ishizaki
1Hakodate Ishikai Hospital, Japan.
Abstract:
To determine if non-insulin-dependent diabetes mellitus (NIDDM) patients with microalbuminuria would have augmented vascular risk factors, we studied the relationships between blood pressure, serum lipids, plasma fibrinogen, and uric acid concentrations and plasma lipoprotein (a) level in 25 Japanese NIDDM patients with microalbuminuria [albumin excretion rate (AER) 20-200 micrograms/min] and 25 individually pair-matched NIDDM patients with normal urinary albumin excretion (AER less than 20 micrograms/min), matched for age, sex, body mass index, treatment and HbAlc level. Microalbuminuric patients had significantly higher systolic blood pressure (p less than 0.05) and plasma fibrinogen level (p less than 0.05) and lower high-density lipoprotein (HDL) cholesterol concentration (p less than 0.05) as compared with those in normoalbuminuric patients, respectively, while there were no differences in serum triglycerides and uric acid levels between the two groups. Plasma lipoprotein (a) level, assessed in 15 microalbuminuric and 15 normoalbuminuric patients, was comparable in the two groups. The results suggest that some of the vascular risk factors are already present in microalbuminuric NIDDM patients when compared with normoalbuminuric patients.
Insights
Microalbuminuria in non-insulin-dependent diabetes mellitus (NIDDM) is linked to increased vascular risks. Patients with microalbuminuria showed higher blood pressure and fibrinogen, and lower HDL cholesterol compared to those without.
Area of Science:
- Endocrinology
- Nephrology
- Cardiovascular Medicine
Background:
- Microalbuminuria is an early sign of diabetic nephropathy.
- Identifying associated vascular risk factors in non-insulin-dependent diabetes mellitus (NIDDM) is crucial for cardiovascular risk management.
Purpose of the Study:
- To investigate whether NIDDM patients with microalbuminuria exhibit augmented vascular risk factors compared to NIDDM patients with normal albumin excretion.
Main Methods:
- A comparative study involving 25 Japanese NIDDM patients with microalbuminuria (albumin excretion rate [AER] 20-200 micrograms/min) and 25 pair-matched NIDDM patients with normal AER (<20 micrograms/min).
- Vascular risk factors assessed included blood pressure, serum lipids, plasma fibrinogen, uric acid, and plasma lipoprotein (a).
- Matching criteria included age, sex, body mass index, treatment, and HbA1c levels.
Main Results:
- Microalbuminuric NIDDM patients demonstrated significantly higher systolic blood pressure (p<0.05) and plasma fibrinogen levels (p<0.05).
- A significantly lower high-density lipoprotein (HDL) cholesterol concentration was observed in the microalbuminuric group (p<0.05).
- No significant differences were found in serum triglycerides or uric acid levels; plasma lipoprotein (a) levels were comparable between groups.
Conclusions:
- NIDDM patients with microalbuminuria present with several established vascular risk factors, including elevated blood pressure and fibrinogen, and reduced HDL cholesterol.
- These findings suggest that microalbuminuria in NIDDM may indicate an early stage of increased cardiovascular risk.
- Early detection and management of these risk factors are warranted in NIDDM patients with microalbuminuria.