Microalbuminuria presents the same vascular risk as overt CVD in type 2 diabetes

Diabetes Res Clin Pract. 2006 Oct;74(1):103-9. doi: 10.1016/j.diabres.2006.03.008. Epub 2006 Apr 18.

Abstract

Objectives: We attempted to assess whether microalbuminuria conferred the same cardiovascular risk as overt CVD in type 2 diabetic patients.

Material and methods: A prospective cohort study including 436 type 2 diabetic patients (64.8+/-9.2 years old) without proteinuria, with follow-up until any cardiovascular event occurred, was performed. Patients were classified into four groups: group 0, non baseline CVD and normoalbuminuria; group 1, non baseline CVD and microalbuminuria; group 2, baseline CVD and normoalbuminuria; group 3, baseline CVD and microalbuminuria. Cox's multivariate regression models were used to assess the risk ratio (RR) associated with each variable.

Results: The median follow-up time was 7.6 years. Incidence rates of cardiovascular events per 1000 patient-years increased from groups 0 to 3 (23.8, 63.4, 74.1, 85.6; p<0.0001). Multivariate RR for incident CVD in groups 1, 2 and 3 in relation to group 0 were 2.8 (95% confidence interval (CI) 1.7-4.6; p<0.0001), 2.7 (95% CI 1.6-4.6; p<0.0001) and 2.9 (95% CI 1.6-5.4; p=0.001), respectively. No significant differences were seen between groups 1 and 2.

Conclusions: We suggest that patients with microalbuminuria are at very high vascular risk and should share the same objectives of a vascular risk-factor control as patients with overt CVD.

MeSH terms

  • Aged
  • Albuminuria / classification
  • Albuminuria / epidemiology*
  • Biomarkers / urine
  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / urine
  • Cohort Studies
  • Diabetes Mellitus, Type 2 / urine*
  • Diabetic Angiopathies / epidemiology*
  • Diabetic Angiopathies / urine
  • Humans
  • Middle Aged
  • Prospective Studies
  • Reference Values
  • Risk Factors

Substances

  • Biomarkers