PREVALENCE AND RISK-FACTORS FOR MICROALBUMINURIA AND MACROALBUMINURIAIN AN ITALIAN POPULATION-BASED COHORT OF NIDDM SUBJECTS

OBJECTIVE - To determine the prevalence of micro- and macroalbuminuria in NIDDM and their relationship with some known and putative risk fac tors. RESEARCH DESIGN AND METHODS - Out of a population-based cohort o f 1,967 NIDDM subjects, 1,574 were investigated (80%). Albumin excreti on rate (AER) was evaluated on an overnight urine collection, and plas ma and urine determinations were centralized. RESULTS - The prevalence s of microalbuminuria (AER 20-200 mu g/min), macroalbuminuria (AER >20 0 mu g/min), and hypertension were 32.1% (95% (CI 29.8-34.4), 17.6% (1 5.7-19.5), and 67% (64.6-69.3), respectively. Apart from prevalence of hypertension, which after adjustment for age, BMI, and duration of di abetes was 2.3 times higher in women, rates were higher in men (odds r atio [OR] 1.31, 95% CI 1.04-1.66 for microalbuminuria and OR 1.63, 1.2 2-2.17 for macroalbuminuria). In comparison with normoalbuminuric subj ects, both micro-and macroalbuminuric diabetic subjects had significan tly longer duration of diabetes, higher levels of systolic blood press ure, fasting plasma glucose, HbA(1c), triglycerides, and uric acid; in macroalbuminuric subjects only, levels of apolipoprotein B and HDL ch olesterol were, respectively, higher and lower than in normo- and micr oalbuminuric subjects. In logistic regression, variables independently related to both micro- and macroalbuminuria were age, HbA(1c), cigare tte smoking habits, plasma uric acid, and diastolic blood pressure. af ter adjustment for plasma creatinine and diabetic treatment. In additi on, duration of diabetes and HDL cholesterol levels were associated wi th macroalbuminuria. CONCLUSIONS - This population-based study showed high prevalence of micro- and macroalbuminuria in NIDDM subjects, who were characterized by a more adverse pattern of cardiovascular risk fa ctors.