Key result
Higher normal urinary albumin-to-creatinine ratio was independently associated with subclinical left ventricular diastolic dysfunction (OR 1.042, P=0.001) and remodeling (OR 1.037, P=0.001).
Why the study?
Is higher normal urinary albumin-to-creatinine ratio associated with subclinical left ventricular diastolic dysfunction and remodeling in patients with and without diabetes?
Observational (n=1,096)
Is higher normal urinary albumin-to-creatinine ratio associated with subclinical left ventricular diastolic dysfunction and remodeling in patients with and without diabetes?
Odds Ratio: 1.042
p-value: p=0.001
Low-grade albuminuria within the normal range is associated with subclinical left ventricular diastolic dysfunction and remodeling, suggesting it may serve as an early marker for cardiovascular damage.
Normal-range UACR may flag early LV changes in diabetes; hypothesis-generating and leaves clinical utility open.
AIMS: Low-grade albuminuria (LGA) has been shown to be associated with increased risk for cardiovascular disease. Our study investigated the relationship between normal urinary albumin-to-creatinine ratios (UACRs) and subclinical left ventricular (LV) diastolic dysfunction and remodeling in diabetics and non-diabetics. METHODS: A total of 888 diabetic and 208 non-diabetic patients with normal UACRs (< 30 mg/g) from Fuzhou, Fujian Province, China were examined. The subjects were stratified into quartiles based on their respective UACR levels. LV diastolic function was defined by early diastolic transmitral velocities (E)/average early diastolic annular velocities (average e), accompanied by average e. LV remodeling was defined by LV mass indexed to body surface area and relative wall thickness based on 2-dimensional and Doppler echocardiography. RESULTS: UACR was independently associated with cardiac diastolic function as defined by E/e and average e (OR=1.042, P=0.001) and LV remodeling (OR=1.037, P=0.001) in all participants. Diabetic patients in the highest quartile of UACR demonstrated a greater risk of developing LV diastolic dysfunction by a magnitude of 1.625 (OR=1.625, P=0.037) than patients in the lowest quartile; those in the third and highest quartiles demonstrated a greater risk of LV remodeling by a magnitude of 1.729-1.994 compared to the lowest quartile (OR=1.729, P=0.027 and OR=1.994, P=0.005, respectively). The association between UACR and subclinical diastolic dysfunction was most prevalent in younger, non-obese, non-hypertensive females or patients who had experienced diabetes for fewer than 10 years. The association between UACR and LV remodeling was most prevalent in non-obese, older males, in patients with normal low-density lipoprotein levels, in patients who had experienced diabetes for fewer than 10 years, and in patients without hypertension. CONCLUSION: UACR was associated with subclinical LV diastolic dysfunction and remodeling in both patients with and without Type 2 diabetes. We conclude that LGA may also be a marker for subclinical cardiovascular damage in Type 2 diabetics.
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Yan et al. (2015) conducted an observational in Type 2 diabetes and non-diabetics (n=1,096). Higher normal urinary albumin-to-creatinine ratio (UACR) vs. Lower UACR (lowest quartile) was evaluated on Cardiac diastolic function (defined by E/e and average e) (OR 1.042, p=0.001). Higher normal urinary albumin-to-creatinine ratio was independently associated with subclinical left ventricular diastolic dysfunction (OR 1.042, P=0.001) and remodeling (OR 1.037, P=0.001).
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