Determinants of albuminuria in people with Type 2 diabetes mellitus

This study sought to identify determinants of albuminuria in people with Ty pe 2 diabetes. In 335 primary care patients, we assessed albumin creatinine ratio (ACR) in two 24-h urine samples, and its cross-sectional association s with protein and alcohol intake, cigarette smoking, body weight and heigh t, glycosuria, blood pressure, hypoglycaemic and antihypertensive treatment , gender, age, age at diagnosis. diabetes duration, family history of diabe tes and cardiovascular diseases, ethnic origin, and education. The prevalen ce of micro- or macro-albuminuria (ACR greater than or equal to 2.0 mg/mmol ) was 33%. Among these patients, compared to those with normo-albuminuria, there were more men, protein intake (g/kg) estimated fl om urinary urea as well as systolic blood pressure and glycosuria were higher, there were more smokers, men were shorter, and a family history of diabetes was less preva lent (all P < 0.05). In linear and logistic regression (n = 270) albuminuri a ia was independently associated (P <less than> 0.05 unless indicated othe rwise) with systolic blood pressure (OR10 (mmHg) = 1.32). smoking (ORex/nev er = 2.36, ORcurrent/never = 4.89), glycosuria (ORgreater than or equal to 7t <t g/l = 2.41). gender (ORmen/women = 2.50), age in men (OR10 year = 1.6 0) (P < 0.10) and, inversely, in women (OR10 year = 0.63) (P <greater than> 0.10). On aggregation, the modifiable determinants systolic blood pressure , smoking and glycosuria explained 12% of the variation in albuminuria. The se factors thus are, although to a moderate extent only, potential determin ants of albuminuria. We also observed an independent, inverse association w ith body height (OR0.10 m = 0.47). This is in line with the hypothesis that development in utero or during early life influences kidney function in la ter life. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.