Is microalbuminuria an integrated risk marker for cardiovascular disease and insulin resistance in both men and women?

Background: Microalbuminuria is associated with some cardiovascular risk fa ctors. However, it is presently unclear whether microalbuminuria is associa ted with other cardiovascular risk factors and markers of insulin resistanc e in both men and women. Design: The baseline parameters of the on-going prospective D.E.S.I.R. Stud y (Data from an Epidemiological Study on the Insulin Resistance syndrome) w ere analysed. Methods: The subjects (n = 3878, age 30-64) had a medical and biological ch eckup including arterial pressure, EGG, lipids, haematocrit, leukocyte coun t, insulin and urinary albumin concentration. Results: Arterial pressure was significantly higher in microalbuminuric tha n in normoalbuminuric men and women. The heart rate and the prevalence of s moking were higher in microalbuminuric than in normoalbuminuric men, but no t in women. Total- and LDL-cholesterol, triglycerides, apolipoprotein-B, le ukocyte count, uric acid, haematocrit, haemoglobin and red cell volume were greater in microalbuminuric than in normoalbuminuric men. Total- and HDL-c holesterol were lower whereas triglycerides and uric acid were significantl y greater in microalbuminuric than in normoalbuminuric women. The g-year ca lculated absolute cardiovascular risk was higher in microalbuminuric than i n normoalbuminuric men (4.18% vs. 2.79%, respectively, P < 0.0001) but was similar in women (0.75% vs. 0.69%, respectively, NS). Fasting blood glucose and insulin were higher in microalbuminuric than in normoalbuminuric men, but not in women. A multiple regression showed that microalbuminuria was as sociated with systolic arterial pressure, fasting glucose, leukocyte count and haematocrit in men, and with systolic arterial pressure and triglycerid es in women. Conclusions: Microalbuminuria is associated with most cardiovascular risk f actors and markers of insulin resistance in men, but no consistent associat ion is observed in women. The determinants of microalbuminuria appear diffe rent in men and women, suggesting a different pathophysiology and perhaps s ignificance of microalbuminuria in men and women. (C) 2001 Lippincott Willi ams & Wilkins.