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Proteinuria in Mexican Americans and Non-Hispanic Whites With NIDDM

  1. Steven M Haffner, MD,
  2. Braxton D Mitchell, PhD,
  3. Jacqueline A Pugh, MD,
  4. Michael P Stern, MD,
  5. M Katherine Kozlowski, MS,
  6. Helen P Hazuda, PhD,
  7. Judith K Patterson, PhD and
  8. Ronald Klein, MD
  1. Division of Clinical Epidemiology, Department of Medicine, University of Texas Health Science Center at San Antonio San Antonio, Texas; and the Department of Ophthalmology, University of Wisconsin Medical School Madison, Wisconsin
  1. Address correspondence and reprint requests to Steven M. Haffner, MD, Division of Clinical Epidemiology, Department of Medicine, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78284.

Abstract

Mexican Americans have a threefold greater prevalence of non-insulin-dependent diabetes mellitus (NIDDM) than non-Hispanic Whites as found in the San Antonio Heart Study, a population-based study of diabetes and cardiovascular disease. In addition, Mexican-American d a etic subjects have higher levels of glycemia than non-Hispanic White diabetic subjects. We therefore hypothesized that the prevalence of clinical proteinuria would be greater among Mexican-American diabetic subjects (n = 317) than among non-Hispanic White diabetic subjects (n = 67). Clinical proteinuria, defined as ≥1 + on the Ames Albustix test, was 2.82 times more prevalent in Mexican-American diabetic subjects compared with non-Hispanic White diabetic subjects adjusting for age and duration (95% confidence interval [Cl] = 1.05, 7.55; P = .039). After controlling for other possible confounding variables (i.e., glycemia, systolic b ood pressure, smoking, and insulin use), the excess of proteinuria in Mexican-American diabetic subjects was only slightly attenuated, although the statistical significance became borderline (odds ratio [OR] = 2.59, 95% Cl = 0.91, 7.32; P = .072). The prevalence of microalbuminuria (>30 mg/L) was also significantly higher in Mexican-American diabetic subjects than in non-Hispanic White diabetic subjects (OR = 3.54, 95% Cl = 1.28, 9.81; P = .015). We also compared previously diagnosed Mexican-American diabetic subjects (n = 243) from San Antonio with previously diagnosed non-Hispanic White diabetic subjects in Wisconsin (n = 476). After controlling for age and duration of diabetes, Mexican-American diabetic subjects had a significantly higher prevalence of clinical proteinuria than the Wisconsin diabetic subjects (Mantel-Haenszel OR = 1.58, 95% Cl = 1.05, 2.40; P = .017). Our data indicate that Mexican-American diabetic ubjects have a higher prevalence of clinical proteinuria and microalbuminuria than non-Hispanic White diabetic subjects.

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