Background: Asian ethnicity is said to be a risk factor for microalbuminuria. Prevalence studies in native Asians, especially Indians, are scarce. The aim was to study the prevalence of microalbuminuria in patients with type 2 diabetes mellitus and to identify the associated risk factors.
Methods: Eight hundred consecutive patients attending the endocrine outpatient clinic were screened. Six hundred seventy patients were eligible for microalbuminuria screening. Urinalysis was done in a random spot urine sample using dipsticks. History, physical examination, and metabolic data were recorded.
Results: The mean age and body mass index of the study population were 52.13 +/- 9.9 years and 26.19 +/- 4.34 kg/m(2), respectively. The median duration of diabetes was 5 years. Microalbuminuria was found in 25.5% (95% confidence interval, 22.4-29%) and macroproteinuria in 16.2% (95% confidence interval, 13.5-19.1%). In patients with duration of diabetes less than 1 year, the prevalence of microalbuminuria was 24.7%, and that of macroproteinuria was 6.2%. The risk factors associated with microalbuminuria and macroproteinuria were glycated hemoglobin, retinopathy, and calcium channel blocker intake. However, waist circumference was negatively associated with macroproteinuria but not with microalbuminuria. This difference in the risk factors supports the newer concept that microalbuminuria and diabetic nephropathy are pathophysiologically different and may not be inextricably linked.
Conclusions: The high proportion of patients who present with albuminuria within the first year of diagnosis probably indicates longer duration of prior undiagnosed diabetes. Screening for asymptomatic diabetes and defining newer risk factors to identify those at risk for complications are essential to reduce the socioeconomic burden of diabetes.