Plasma lipids and urinary albumin excretion rate in Type 1 diabetes mellitus: the EURODIAB IDDM Complications Study

Aims To examine the relationship between increased urinary albumin excretio n rate and fasting plasma lipids among male and female respondents to the E URODIAB IDDM Complications Study, and attempt to explain inconsistencies in previous reports. Methods A cross-sectional study of 3250 randomly selected Type 1 diabetic p atients from 31 diabetes clinics in 16 European countries was carried out b etween 1989 and 1990. Plasma lipids and urinary albumin were measured centr ally. The present analysis was confined to the subgroup of 2205 patients at tending after a 10-12 h overnight fast. Mean age was 33 years (SD 10) and m ean duration of Type 1 diabetes mellitus was 15 years (SD 9). Results The prevalence of microalbuminuria (24-h urinary albumin excretion rate 20-200 mug/min) was 21.7% (95% confidence interval 19.9-23.5) and macr oalbuminuria (24-h urinary albumin excretion rate > 200 mug/min) 7.8% (6.6- 9.0). In comparison to patients with normal urinary albumin excretion rate (< 20 <mu>g/min), and after controlling for age, sex, glycaemic control, du ration of diabetes and current smoking, macroalbuminuria was associated wit h significantly (P < 0.01) increased fasting plasma triglycerides, choleste rol, LDL-cholesterol, cholesterol:HDL-cholesterol ratio and, in women, redu ced HDL-cholesterol. In men and women with microalbuminuria, the only signi ficant association was with increased plasma triglycerides. Conclusions These data confirm that there is an association between fasting plasma lipids and increasing urinary albumin excretion rate in European Ty pe 1 diabetic patients. In microalbuminuric patients, however, the associat ion was weaker than previously reported and partly explained by confounding factors.