Risk factors for microalbuminuria in Black Americans with newly diagnosed type 2 diabetes

We conducted a cross-sectional analysis to describe the prevalence of and r isk factors for microalbuminuria among blacks with newly diagnosed type 2 d iabetes. Black adults with diagnosed type 2 diabetes mellitus of 2 years' d uration or less who presented for care to the Grady Diabetes Clinic (Atlant a, GA) between January 1, 1994, and December 31, 1996, were eligible (n = 1 ,167), Information obtained at the initial visit included age; sex; body ma ss index (BMI); serum total cholesterol, high-density lipoprotein cholester ol, low-density lipoprotein cholesterol, triglyceride, C-peptide, serum cre atinine, and hemoglobin A1c (HbA(1c)) levels; and seated systolic and diast olic blood pressures. Outcome was urine albumin-creatinine (Alb/Cr) ratio a t the initial visit. Alb/Cr ratios were categorized as normal (Alb/Cr <25 < mu>g/mg), microalbuminuric (Alb/Cr, 25 to 250 mug/mg), and macroalbuminuric (Alb/Cr >250 mug/mg). Patients with macroalbuminuria or creatinine levels of 2 mg/dL or greater were excluded. We used multiple linear regression to assess the joint association between HbA(1c) level, mean arterial pressure (MAP), and log-transformed Alb/Cr, controlling for other covariates, Of 1,0 44 patients studied, macroalbuminuria was present in 3.8%, and microalbumin uria, in 23.4%, Alb/Cr was independently associated with increased HbA(1c) level (P = 0.0070), MAP (P = 0.0001), BMI (P = 0.0156), log-transformed tri glyceride levels (P = 0.0031), C-peptide level of ;6.5 ng/mL or greater (P = 0.0007), serum creatinine level (P = 0.0068), and male sex (P = 0.0220). The relationship between HbA(1c) level and microalbuminuria was stronger in patients with lower BMIs, Microalbuminuria prevalence was high in this pop ulation of urban blacks with newly diagnosed type 2 diabetes. Risk factors associated with increased Alb/Cr included male sex, poor glycemic control, endogenous hyperinsulinemia, high blood pressure, elevated triglyceride lev els, and obesity. (C) 2000 by the National Kidney Foundation, Inc.