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Association Between Urinary Albumin Excretion and Serum Dehydroepiandrosterone Sulfate Concentration in Male Patients With Type 2 Diabetes

A possible link between urinary albumin excretion and cardiovascular disease

¹ Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
² Department of Endocrinology and Hematology, Osaka General Hospital of West Japan Railway Company, Osaka, Japan

Address correspondence and reprint requests to Michiaki Fukui, MD, Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan. E-mail: sayarinapm{at}hotmail.com

OBJECTIVE—Cardiovascular disease (CVD) is the leading cause of mortality and morbidity in patients with type 2 diabetes. Both elevated urinary albumin excretion and low serum concentrations of dehydroepiandrosterone (DHEA) are associated with increased CVD mortality. This raises the possibility of DHEA as a causal intermediate linking urinary albumin excretion to CVD.

RESEARCH DESIGN AND METHODS—Relationships of urinary albumin excretion to serum DHEA sulfate (DHEA-S) concentration and to major cardiovascular risk factors, including blood pressure, serum lipid concentration, glycemic control (HbA_1c), and BMI, were investigated in 357 consecutive men with type 2 diabetes.

RESULTS—Serum DHEA-S concentrations were lower in patients with macroalbuminuria (866.5 ± 523.8 ng/ml, P < 0.0001) and in those with microalbuminuria (1,014.4 ± 525.3 ng/ml, P = 0.0006) than in patients with normoalbuminuria (1,232.6 ± 542.4 ng/ml). Serum DHEA-S concentration correlated inversely with log (urinary albumin excretion) (r = –0.227, P < 0.0001). Multiple regression analysis demonstrated that duration of diabetes (ß = 0.147, P = 0.0075), HbA_1c (ß = 0.156, P = 0.0048), BMI (ß = 0.194, P = 0.0007), systolic blood pressure (ß = 0.195, P = 0.0005), and serum DHEA-S concentration (ß = –0.192, P = 0.0010) were independent determinants of log (urinary albumin excretion).

CONCLUSIONS—Serum DHEA-S concentration, which correlated inversely with degree of urinary albumin excretion, may contribute to the link between elevated urinary albumin excretion and higher CVD mortality in male patients with type 2 diabetes.

Abbreviations: CVD, cardiovascular disease • DHEA, dehydroepiandrosterone • DHEA-S, DHEA sulfate

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				M. Fukui, H. Ose, I. Nakayama, H. Hosoda, M. Asano, M. Kadono, S.-i. Mogami, G. Hasegawa, T. Yoshikawa, and N. Nakamura Association Between Urinary Albumin Excretion and Serum Dehydroepiandrosterone Sulfate Concentrations in Women With Type 2 Diabetes Diabetes Care, July 1, 2007; 30(7): 1886 - 1888. [Full Text] [PDF]