Significant independent predictors of developing microalbuminuria over 2 years in individuals with IDDM were HbA1 (P<0.001), LDL (P<0.01), IDDM duration (P<0.05), and systolic BP (P=0.05).
Cohort (n=256)
Glycemic control, disturbed lipids, and elevated blood pressure contribute to the development of microalbuminuria in individuals with IDDM, suggesting adverse cardiovascular risk profiles begin developing before microalbuminuria detection.
OBJECTIVE: To examine the relationships between microalbuminuria and the development of overt diabetic nephrology, elevated blood pressure, and a more atherogenic lipid profile; and to identify risk factors for the development of microalbuminuria in individuals with IDDM. Microalbuminuria has been associated with the subsequent development of overt diabetic nephropathy in individuals with IDDM. It is associated with elevated blood pressure and a more atherogenic lipid profile, but the temporal relationship between the development of microalbuminuria and the changes in these factors is unclear. RESEARCH DESIGN AND METHODS: Baseline characteristics were examined in 256 individuals with IDDM who had normal albumin excretion (urinary AER or = 2 timed urine collections) and were re-examined 2 yr later. RESULTS: At follow-up, 24 had developed microalbuminuria (AER 20-200 micrograms/min in > or = 2 timed urine collections) and 1 had developed overt nephropathy (AER > 200 micrograms/min). Overall, the significant independent predictors of microalbuminuria were HbA1 (P 20-yr duration. Low-density lipoprotein cholesterol was more important for subjects with shorter durations; whereas triglycerides were important for those with longer durations. CONCLUSIONS: These results suggest that glycemic control, age or duration of IDDM, disturbed lipids, and possibly elevated blood pressure all may contribute to the development of microalbuminuria; and, further, that the adverse cardiovascular risk profile seen in individuals with overt nephropathy may begin to develop even before the detection of microalbuminuria.
Coonrod et al. (Fri,) conducted a cohort in Insulin-Dependent Diabetes Mellitus (IDDM) (n=256). HbA1, LDL, IDDM duration, and systolic blood pressure was evaluated on Development of microalbuminuria (AER 20-200 μg/min). Significant independent predictors of developing microalbuminuria over 2 years in individuals with IDDM were HbA1 (P<0.001), LDL (P<0.01), IDDM duration (P<0.05), and systolic BP (P=0.05).