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Microalbuminuria and cardiovascular risk factors in type 2 diabetes mellitus

J Allawi1, R J Jarrett

  • 1Division of Medicine, United Medical School, Guy's Hospital, London, UK.

Insights

Increased urinary albumin excretion (AER) in Type 2 diabetes patients is linked to higher diastolic blood pressure and heart rate. This suggests AER

Area of Science:

  • Cardiology
  • Nephrology
  • Endocrinology

Background:

  • Elevated urinary albumin excretion (AER) is a known risk factor for cardiovascular events in Type 2 diabetes mellitus.
  • The precise relationship between AER and cardiovascular disease (CVD) risk factors requires further elucidation.

Purpose of the Study:

  • To investigate the association between overnight albumin excretion rate (AER) and cardiovascular disease risk factors in non-insulin-treated Type 2 diabetes patients under 65.
  • To determine if conventional risk factors explain the link between raised AER and cardiovascular risk.

Main Methods:

  • Prospective study of 85 Type 2 diabetes patients (age < 65, no insulin).
  • Measured overnight albumin excretion rate (AER) and analyzed its correlation with diastolic blood pressure, heart rate, body mass index, waist-hip ratio, HDL-cholesterol, and Factor VII levels.
  • Patients categorized into high-risk (AER ≥ 10 µg/min) and low-risk (AER < 10 µg/min) groups for comparative analysis.

Main Results:

  • Albumin excretion rate (AER) showed a significant correlation with both seated and supine diastolic blood pressure and resting heart rate.
  • While the high-risk AER group exhibited higher body mass index, waist-hip ratio, and lower HDL-cholesterol, these differences were not statistically significant.
  • Factor VII levels did not significantly differ between the high-risk and low-risk AER groups.

Conclusions:

  • The study indicates a significant association between albumin excretion rate (AER) and cardiovascular risk markers like diastolic blood pressure and heart rate in Type 2 diabetes.
  • Conventional cardiovascular risk factors do not fully account for the cardiovascular risk associated with elevated AER.
  • Further research is needed to understand the underlying mechanisms linking AER to cardiovascular morbidity and mortality in this population.

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