|
 |
|
|||||||
|
|||||||||
© 2005 by the American Diabetes Association, Inc.
Metabolic Syndrome/Insulin Resistance Syndrome/Pre-Diabetes |
Urinary Albumin Excretion and Its Relation With C-Reactive Protein and the Metabolic Syndrome in the Prediction of Type 2 Diabetes
1 Division of Nephrology, Department of Medicine, University Medical Center Groningen, Groningen, the Netherlands
2 Department of Medicine, University Medical Center Groningen, Groningen, the Netherlands
3 Trial Coordination Center, Department of Cardiology, University Medical Center Groningen, Groningen, the Netherlands
4 Department of Clinical Pharmacology, University Medical Center Groningen, Groningen, the Netherlands
Address correspondencereprint requests to Ronald T. Gansevoort, MD, PhD, Division of Nephrology, Dept. of Medicine, University Medical Center Groningen, P.O. Box 30,001, 9700 RB, Groningen, Netherlands. E-mail: r.t.gansevoort{at}int.umcg.nl
OBJECTIVE—To investigate urinary albumin excretion (UAE) and its relation with C-reactive protein (CRP) and the metabolic syndrome in the prediction of the development of type 2 diabetes.
RESEARCH DESIGN AND METHODS—We used data from the Prevention of Renal and Vascular End Stage Disease (PREVEND) study, an ongoing, community-based, prospective cohort study initiated in 1997 in the Netherlands. The initial cohort consisted of 8,592 subjects. After 4 years, 6,894 subjects participated in a follow-up survey. Subjects with diabetes at baseline or missing data on fasting glucose were excluded, leaving 5,654 subjects for analysis. The development of type 2 diabetes, defined as a fasting glucose 
7.0 mmol/l and/or the use of antidiabetic medication, was used as the outcome measure. UAE was calculated as the mean UAE from two consecutive 24-h urine collections. Logistic regression models were used, with the development of type 2 diabetes as the dependent variable.
RESULTS—Of the 5,654 subjects for whom data were analyzed, 185 (3.3%) developed type 2 diabetes during a mean follow-up period of 4.2 years. UAE, CRP, and the presence of the metabolic syndrome at baseline were significantly associated with the incidence of type 2 diabetes (P < 0.001 for all variables). In a univariate model, the odds ratio (OR) for UAE was 1.59 (95% CI 1.42–1.79). In our full model, adjusted for age, sex, number of criteria of metabolic syndrome, and other known risk factors for the development of type 2 diabetes (including fasting insulin), the association between UAE and type 2 diabetes remained significant (OR 1.53, 95% CI 1.25–1.88, P < 0.001). There was a significant interaction between UAE and CRP (P = 0.002). After CRP was stratified into tertiles, the ORs for the association between baseline UAE and the development of type 2 diabetes were 2.2 (1.47–3.3), 1.33 (0.96–1.84), and 1.04 (0.83–1.31) for the lowest to highest tertiles, respectively.
CONCLUSIONS—UAE predicts type 2 diabetes independent of the metabolic syndrome and other known risk markers of development of type 2 diabetes. The predictive value of UAE was modified by the level of CRP.
Abbreviations: AUC, area under the curve • CRP, C-reactive protein • PREVEND, Prevention of Renal and Vascular End Stage Disease • UAE, urinary albumin excretion
CiteULike 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
This article has been cited by other articles:
|
|
 |
|
  W. Kosmala, T. M. O'Moore-Sullivan, R. Plaksej, J. Kuliczkowska-Plaksej, M. Przewlocka-Kosmala, and T. H. Marwick Subclinical Impairment of Left Ventricular Function in Young Obese Women: Contributions of Polycystic Ovary Disease and Insulin Resistance J. Clin. Endocrinol. Metab., October 1, 2008; 93(10): 3748 - 3754. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. H. Brantsma, S. J.L. Bakker, D. de Zeeuw, P. E. de Jong, R. T. Gansevoort, and for the PREVEND Study Group Extended Prognostic Value of Urinary Albumin Excretion for Cardiovascular Events J. Am. Soc. Nephrol., September 1, 2008; 19(9): 1785 - 1791. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Haraldsson, J. Nystrom, and W. M. Deen Properties of the Glomerular Barrier and Mechanisms of Proteinuria Physiol Rev, April 1, 2008; 88(2): 451 - 487. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. E. de Jong and R. T. Gansevoort Fact or fiction of the epidemic of chronic kidney disease--let us not squabble about estimated GFR only, but also focus on albuminuria Nephrol. Dial. Transplant., April 1, 2008; 23(4): 1092 - 1095. [Full Text] [PDF]
|
|
|
|
 |
|
 W. H.A. de Jong, K. S. Graham, J. C. van der Molen, T. P. Links, M. R. Morris, H. A. Ross, E. G.E. de Vries, and I. P. Kema Plasma Free Metanephrine Measurement Using Automated Online Solid-Phase Extraction HPLC Tandem Mass Spectrometry Clin. Chem., September 1, 2007; 53(9): 1684 - 1693. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Ingelsson, J. Sundstrom, L. Lind, U. Riserus, A. Larsson, S. Basu, and J. Arnlov Low-grade albuminuria and the incidence of heart failure in a community-based cohort of elderly men Eur. Heart J., July 2, 2007; 28(14): 1739 - 1745. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. R. Weir Microalbuminuria and Cardiovascular Disease Clin. J. Am. Soc. Nephrol., May 1, 2007; 2(3): 581 - 590. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Z. Wang and W. E Hoy Albuminuria as a marker of the risk of developing type 2 diabetes in non-diabetic Aboriginal Australians Int. J. Epidemiol., October 1, 2006; 35(5): 1331 - 1335. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. E. de Jong and G. C. Curhan Screening, Monitoring, and Treatment of Albuminuria: Public Health Perspectives J. Am. Soc. Nephrol., August 1, 2006; 17(8): 2120 - 2126. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. de Zeeuw, H.-H. Parving, and R. H. Henning Microalbuminuria as an Early Marker for Cardiovascular Disease J. Am. Soc. Nephrol., August 1, 2006; 17(8): 2100 - 2105. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| Diabetes | Diabetes Care | Clinical Diabetes | Diabetes Spectrum |