Albuminuria in Australian Aboriginal people: prevalence and associations with components of the metabolic syndrome

Diabetologia. 2000 Nov;43(11):1397-403. doi: 10.1007/s001250051545.

Abstract

Aims/hypothesis: To examine the prevalence and associations with the metabolic syndrome of albuminuria among Australian Aboriginal people.

Methods: Early-morning urine specimens were collected as part of community-based risk factor surveys assessing the prevalence of diabetes and cardiovascular disease in eight remote communities, with a sample size of 1,075 people. Microalbuminuria was defined as urinary albumin : creatinine ratio 3.4-33.9 mg/mmol, macroalbuminuria as albumin: creatinine ratio equal to or greater than 34 mg/mmol.

Results: There were high prevalences of microalbuminuria (men 22.2 %, women 26.9 %) and of macroalbuminuria (men 10.4%, women 13.5%). There were highly statistically significant linear associations of microalbuminuria and macroalbuminuria with increasing number of coexisting components of the metabolic syndrome (hypertension, glucose intolerance, dyslipidaemia, insulin resistance, abdominal obesity): among people with zero, one, two and three to five of these conditions, respectively, prevalence of microalbuminuria was 16%, 20%, 36% and 32% (p < 0.001); prevalence of macroalbuminuria was 2%, 6%, 12% and 32% (p < 0.001). There were independent associations of microalbuminuria with hypertension (odds ratio, 95% confidence interval = 2.36, 1.63-3.42) and diabetes (2.10, 1.28-3.45): macroalbuminuria was independently associated with hypertension (6.39, 3.93-10.4), diabetes (3.49, 1.93-6.28) and abdominal obesity (4.56, 2.40-8.64) and had a weaker association with insulin resistance (1.99, 1.12-3.54). Dyslipidaemia and impaired glucose tolerance were neither independently associated with microalbuminuria or macroalbuminuria, nor was insulin resistance or abdominal obesity independently associated with microalbuminuria.

Conclusion/interpretation: There was a strong clustering of albuminuria with components of the metabolic syndrome. Diabetes, hypertension and abdominal obesity are major contributors to high rates of albuminuria among Australian Aboriginal people.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aging
  • Albuminuria / complications
  • Albuminuria / epidemiology*
  • Australia / epidemiology
  • Body Mass Index
  • Creatinine / urine
  • Female
  • Glucose Intolerance
  • Humans
  • Hyperlipidemias / complications
  • Hyperlipidemias / epidemiology*
  • Hyperlipidemias / urine
  • Hypertension / complications
  • Hypertension / epidemiology*
  • Hypertension / urine
  • Insulin Resistance*
  • Male
  • Middle Aged
  • Native Hawaiian or Other Pacific Islander*
  • Obesity / complications
  • Obesity / epidemiology*
  • Obesity / urine
  • Odds Ratio
  • Urinary Tract Infections / epidemiology

Substances

  • Creatinine