title: Pre-diabetic blood pressure predicts urinary albumin excretion after the onset of type 2 (non-insulin-dependent) diabetes mellitus in Pima Indians.
abstract: Blood pressure was measured in 490 non-proteinuric Pima Indians from the Gila River Indian Community in Arizona at least 1 year before the diagnosis of Type 2 (non-insulin-dependent) diabetes mellitus. Urine albumin concentration was measured in the same subjects 0-24 years (mean 5 years) after diabetes was diagnosed. Prevalence rates of abnormal albumin excretion (albumin-to-creatinine ratio > or = 100 mg/g) after the onset of Type 2 diabetes were 9%, 16%, and 23%, respectively, for the lowest to highest tertiles of pre-diabetic mean blood pressure. When controlled for age, sex, duration of diabetes and pre-diabetic 2-h post-load plasma glucose concentration, higher pre-diabetic mean blood pressure predicted abnormal urinary excretion of albumin after the onset of diabetes. This finding suggests that the higher blood pressure seen in diabetic nephropathy is not entirely a result of the renal disease, but may precede and contribute to it.
authors.affiliation: Department of Biostatistics and Epidemiology, Cleveland Clinic Foundation, Phoenix, Arizona.
authors.forename: R G
authors.initials: RG
authors.lastname: Nelson
authors.forename: D J
authors.initials: DJ
authors.lastname: Pettitt
authors.forename: H R
authors.initials: HR
authors.lastname: Baird
authors.forename: M A
authors.initials: MA
authors.lastname: Charles
authors.forename: Q Z
authors.initials: QZ
authors.lastname: Liu
authors.forename: P H
authors.initials: PH
authors.lastname: Bennett
authors.forename: W C
authors.initials: WC
authors.lastname: Knowler
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000419:Albuminuria / Q000453:epidemiology; D001130:Arizona; D001794:Blood Pressure; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology / Q000652:urine*; D005260:Female; D006801:Humans; D007198:Indians, North American; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011236:Prediabetic State / Q000503:physiopathology*; D015995:Prevalence; D011379:Prognosis; D012044:Regression Analysis; D012737:Sex Factors