URINARY ALBUMIN EXCRETION RATE AND CARDIOVASCULAR-DISEASE IN SPANIARDTYPE-2 DIABETIC-PATIENTS

To assess the prevalence of urinary albumin excretion abnormalities an d their associations with cardiovascular disease or its classical risk factors in type 2 diabetes mellitus, 1348 clinic-proceeding patients have been studied retrospectively. The overnight urinary albumin excre tion rate, blood pressure, smoking, ophthalmic and cardiovascular stat us, current therapies, estimates of glycemic control, plasma lipids, s erum creatinine and uric acid have been ascertained. 767 (56.8%) patie nts were found normoalbuminuric, 461 (34.1%) microalbuminuric and 120 (8.9%) macroalbuminuric. In bivariate analyses, the urinary albumin ex cretion rate had statistically significant (P < 0.05) relationships wi th age, duration of diabetes, male sex, waist-to-hip ratio, systolic a nd diastolic pressure, coronary heart disease, cerebrovascular disease , peripheral vascular disease, hypertension, antihypertensive therapy, laser-treated retinopathy, kind of treatment, smoking habit, fasting glycaemia, HbA(1c), creatinine, uric acid, triglycerides, high density lipoprotein (HDL)-cholesterol and apolipoprotein B. Borderline statis tically significant (P < 0.1) relationships were found with hypolipida emic therapy, insulin dose, non-HDL-cholesterol, apolipoprotein A(1) a nd lipoprotein (a). In a multivariate stepwise logistic regression mod el, HbA(1c), hypertension, male sex, age, diastolic blood pressure, co ronary heart disease and body-mass index were sequentially selected as variables independently associated with microalbuminuria. Serum creat inine, HbA(1c), male sex and hypertension were sequentially selected a s independently associated with macroalbuminuria. Micro and macroalbum inuria are frequent abnormalities associated with poorly controlled an d complicated disease, with overt cardiovascular disease and its class ical risk factors as well;as with the male sex. (C) 1997 Elsevier Scie nce Ireland Ltd.