Microalbuminuria, central adiposity and hypertension in the non-diabetic urban population of the MONICA Augsburg survey 1994/95

Objective: Microalbuminuria is a renal marker of general vascular endotheli al damage and early atherosclerosis with adverse prognostic implications. M icroalbuminuria is associated with diabetes, insulin resistance, central ad iposity and hypertension. We evaluated the degree of the association of com ponents of the metabolic syndrome with microalbuminuria in a subsample of a nondiabetic study population. Design: Men and women aged 25-74 living in the city of Augsburg, Germany, w ere interviewed and examined in a standardised manner at a population-based survey conducted in 1994/95. Persons with a history of diabetes or HbA1c l evel greater than or equal to7% were excluded. Outcome: Albumin and creatinine were determined quantitatively in a spot ur ine and defined as microalbuminuria via an albumin/creatinine ratio between 30 and 299 mg/g. Results: Among 920 men and 879 women, the age-standardised prevalence of mi croalbuminuria was 8.0% and 7.5%, respectively. While a graded, positive in crease in prevalence of microalbuminuria across quintiles of waist-to-hip ( WHR) was observed in non-hypertensive men and women, microalbuminuria was u niformly high among hypertensives. Multivariate logistic regression models showed that central adiposity (OR 3.3) or hypertension (OR 4.0) alone signi ficantly increased the odds of microalbuminuria while their joint presence (OR 3.6) did not add to the occurrence of microalbuminuria. While obesity w as not associated with microalbuminuria once central adiposity was taken in to account, elevated percent body fat remained associated with microalbumin uria. Conclusions: Signs of early endothelial dysfunction as manifested as microa lbuminuria are strongly and independently associated with central adiposity and should be considered in the context of the metabolic or insulin resist ance syndrome.