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Atherosclerotic risk factors are increased in clinically healthy subjects with microalbuminuria
J S Jensen1, K Borch-Johnsen, G Jensen
1Steno Diabetes Center, Gentofte, Denmark.
Abstract:
Increased morbidity and mortality from atherosclerotic vascular disease were observed in subjects with slightly elevated urinary albumin excretion rate (UAER), known as microalbuminuria. Therefore, the association between microalbuminuria and established atherogenic risk factors was studied in clinically healthy subjects. All healthy 40-65 year-old participants with microalbuminuria, examined within the first 21 months of The Copenhagen City Heart Study, were invited, and 28 were studied. An age- and sex-matched group of 60 randomly chosen subjects with normoalbuminuria served as control. Microalbuminuria was defined as a UAER of 6.6-150 micrograms/min, and normoalbuminuria as a UAER < or = 6.6 micrograms/min. In the microalbuminuric group, systolic and diastolic blood pressures were both elevated (mean (95% C.I.) 128 (123-134) vs. 119 (116-122) mmHg; P = 0.005, and 75 (71-78) vs. 69 (67-71) mmHg; P = 0.008, respectively), and serum apolipoprotein (apo) A-1 concentration was lower (1.30 (1.20-1.37) vs. 1.42 (1.36-1.47) milligrams; P = 0.02) in comparison with the normoalbuminuric group. Furthermore, serum HDL-cholesterol concentration tended to be lower, whereas body weight, body mass index and fasting serum insulin concentration were slightly elevated in the microalbuminuric group but not statistically significant. It is concluded that microalbuminuria in clinically healthy subjects is associated with increased levels of atherogenic risk factors. This may contribute to the increased vascular morbidity and mortality observed in these individuals.
Insights
Microalbuminuria, a marker of kidney dysfunction, is linked to higher risks of cardiovascular disease in healthy adults. This condition is associated with elevated blood pressure and lower levels of protective apolipoprotein A-1.
Area of Science:
- Cardiology
- Nephrology
- Metabolic Syndrome
Background:
- Microalbuminuria (elevated urinary albumin excretion rate) is associated with increased cardiovascular morbidity and mortality.
- Understanding the link between microalbuminuria and atherogenic risk factors in healthy individuals is crucial for early intervention.
Purpose of the Study:
- To investigate the association between microalbuminuria and established atherogenic risk factors in clinically healthy subjects.
- To identify specific risk factors that may contribute to the increased vascular risk observed in individuals with microalbuminuria.
Main Methods:
- A case-control study involving 28 healthy adults with microalbuminuria and 60 age- and sex-matched controls with normoalbuminuria.
- Measurements included blood pressure, serum apolipoprotein A-1, HDL-cholesterol, body weight, body mass index, and fasting serum insulin.
- Microalbuminuria was defined as a urinary albumin excretion rate of 6.6-150 µg/min.
Main Results:
- Microalbuminuric subjects exhibited significantly higher systolic and diastolic blood pressures compared to controls.
- Serum apolipoprotein A-1 concentration was significantly lower in the microalbuminuria group.
- Trends towards lower HDL-cholesterol and slightly elevated body weight, BMI, and insulin were observed but not statistically significant.
Conclusions:
- Microalbuminuria in clinically healthy individuals is associated with an increased presence of atherogenic risk factors.
- These findings suggest that microalbuminuria may play a role in the elevated vascular morbidity and mortality observed in these subjects.