PREVALENCE OF MICROALBUMINURIA, LIPOPROTEIN (A) AND CORONARY-ARTERY DISEASE IN THE LIPID CLINIC

Aims-To assess the prevalence of micro-albuminuria (MA) and elevated s erum lipoprotein (a) (Lp (a)) concentration, and their association wit h coronary artery disease (CAD) and other conventional cardiovascular risk factors in non-diabetic patients attending a lipid clinic. Method s-Clinical details were obtained from 96 consecutive non-diabetic pati ents from whom a fasting blood sample was taken to measure serum lipid , lipoprotein, apolipoprotein and plasma glucose, urea, and electrolyt e concentrations. The urine albumin/creatinine ratio (U-a/U-c) was est imated from a random clinic sample. Results-Of the patients, 26% had M A (defined as a U-a/U-c > 2.2 mg/mu mol), 38% had an elevated Lp (a) c oncentration (defined as > 0.4 g/l), 36% were hypertensive (blood pres sure > 160/95) or were taking antihypertensive medication, and 25% had established CAD defined on clinical criteria. In men the U-a/U-c rati o was highly associated with age, plasma low density lipoprotein chole sterol, and triglyceride concentrations. In women there was no associa tion between the U-a/U-c ratio and variables examined. Lp (a) concentr ation was not associated with variables examined in either sex. In mul tiple logistic regression analysis adjusted for age and sex, serum Lp (a) concentration, diastolic blood pressure and treatment of hyperlipi daemia were highly associated with CAD. MA was not, however, associate d with CAD. Conclusions-MA is common in a lipid clinic and is more Lik ely to be found among older male patients with hyperlipidaemia. Howeve r, in contrast with Lp (a) concentrations, MA is not a risk factor for CAD in this high risk population. Lp (a) concentration may be a usefu l tool in the lipid clinic, but there does not seem to be a justificat ion for measuring the U-a/U-c ratio, at least in non-diabetic subjects .