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Microalbuminuria in elderly hyperglycaemic patients and controls
Diabetic Medicine : a Journal of the British Diabetic Association
|September 1, 1986
Summary
Occult fasting hyperglycemia in older adults is linked to kidney damage, specifically increased albuminuria, particularly in males. This early kidney dysfunction, a form of non-insulin-dependent diabetes mellitus, is of glomerular origin.
Area of Science:
- Nephrology
- Endocrinology
- Geriatrics
Background:
- Elderly populations exhibit a broad spectrum of albumin excretion rates.
- Non-insulin-dependent diabetes mellitus (NIDDM) is prevalent in older adults.
- Early detection of diabetic kidney disease is crucial.
Purpose of the Study:
- To investigate the association between occult fasting hyperglycemia (FH) and kidney function in older adults.
- To determine sex differences in albuminuria in individuals with FH and known NIDDM.
- To ascertain the origin of increased albumin excretion in these groups.
Main Methods:
- Screening of a well-defined population aged 60-74 years.
- Examination of 1781 subjects with FH, 211 with known diabetes (KD), and controls.
- Analysis of urine albumin, beta 2-microglobulin excretion, and creatinine clearance.
Main Results:
- Occult FH is associated with increased albuminuria in males, undetectable by conventional tests.
- Females with occult FH did not show increased microalbuminuria, suggesting a sex-specific threshold.
- Known NIDDM showed increased albuminuria in both sexes; the albumin/beta 2-microglobulin ratio indicated glomerular origin.
Conclusions:
- Occult fasting hyperglycemia in older adults is an early indicator of glomerular kidney damage.
- Sex differences exist in the manifestation of microalbuminuria in elderly individuals with FH.
- Screening for early kidney dysfunction in elderly individuals with hyperglycemia is warranted.