Microalbuminuria associated with diabetic neuropathy.
OBJECTIVE
To test the hypothesis that microalbuminuria may show an independent statistical association with diabetic neuropathy.


METHODS
An observational study of a prospectively identified cohort was conducted at the University Medical Center. The cohort consisted of 78 consecutive diabetic patients who fulfilled the criteria of having diabetes for greater than 10 yr, a normal serum creatinine, urine negative for macroalbuminuria by a commonly used dipstick method, a blood glucose less than 13.8 mM (less than 250 mg/dl), and an HbA1 less than 11% (normal range 5.5-8.5%). Medical record review established the presence of chronic complications of diabetes. Urine albumin level was measured by radioimmunoassay. Albumin concn greater than or equal to 15 mg/L was used as a cutoff value for microalbuminuria.


RESULTS
Twenty-five of 78 patients (32%) showed microalbuminuria. Of these, 51% had neuropathy, 39% had retinopathy, 35% arterial hypertension, 17% peripheral vascular disease, and 15% ischemic heart disease. After adjusting for age, sex, and type and duration of diabetes, diabetic neuropathy and hypertension showed a significant association with microalbuminuria. After adjusting for other diabetic complications, diabetic neuropathy showed a significant association with microalbuminuria.


CONCLUSIONS
Microalbuminuria is independently associated with diabetic neuropathy. This association lends support to the theory of a vascular etiology for diabetic distal symmetrical neuropathy.
Bell
D S
DS
Department of Medicine, School of Medicine, University of Alabama, Birmingham.
Ketchum
C H
CH
Robinson
C A
CA
Wagenknecht
L E
LE
Williams
B T
BT
D000419:Albuminuria; D015415:Biomarkers / Q000652:urine; D001786:Blood Glucose / Q000032:analysis; D015331:Cohort Studies; D003327:Coronary Disease / Q000150:complications / Q000652:urine; D003925:Diabetic Angiopathies / Q000652:urine; D003929:Diabetic Neuropathies / Q000097:blood / Q000503:physiopathology / Q000652:urine*; D003930:Diabetic Retinopathy / Q000652:urine; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000652:urine; D011446:Prospective Studies; D014652:Vascular Diseases / Q000150:complications / Q000652:urine
D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin