THE PREVALENCE OF PERIPHERAL VASCULAR-DISEASE IN TYPE-2 DIABETIC-PATIENTS WITH AND WITHOUT PROTEINURIA

It has been reported that albumin excretion rate may reflect not only an indication of renal disease but also a widespread vascular damage. We studied the relationship between overnight albumin excretion rate ( AER) and peripheral vascular disease (PVD), using Doppler ultrasound, and its major risk factors in 80 Type 2 (non-insulin-dependent) diabet ic patients. Thirty-eight of these patients had normoalbuminuria (AER < 30 mug/min), 22 had microalbuminuria (30-200 mug/min) and 20 had mac roalbuminuria (> 200 mug/min). Patients with normoalbuminuria were old er than those with normoalbuminuria (p < 0.01) and they also had a lon ger duration of diabetes (p < 0.05). Pateints with elevated albumin ex cretion rates had elevated prevalence of PVD (macroalbuminuric 40%, p < 0.01; microalbuminuric 27.2%, p < 0.05; vs normoalbuminuric 7.8%). A mong the risk factors analysed, hypertension and triglyceride concentr ations were higher in the proteinuric diabetics (macroalbuminuric p < 0.001, p < 0.01; microalbuminuric p = NS, p < 0.01 respectively), whil e HDL-C levels were found to be significantly lower in this group (p < 0.05). In the diabetic group as a whole, raised AER was correlated wi th PVD (p < 0.05), duration of diabetes and systolic blood pressure (p < 0.01). We conclude that the prevalence of PVD was significantly hig her in Type 2 diabetic patients with elevated albumin excretion rate. Furthermore, these patients had higher blood pressure and low HDL-C.