Utility of untimed urinary albumin measurements in assessing albuminuria in black NIDDM subjects.
OBJECTIVE
To determine the usefulness of an untimed morning urine specimen in screening a black NIDDM population attending an urban diabetes clinic for microalbuminuria.


METHODS
Untimed morning specimens were provided by 218 black NIDDM subjects. Of the 218 subjects, 123 also provided 24-h urine specimens. The 24-h specimens were assayed for albumin excretion rate (AER) in milligrams per 24 h, and the albumin-to-creatinine ratio (A-to-C) in micrograms per milligram was determined on the untimed morning urine specimen.


RESULTS
Correlation between the A-to-C ratio and the 24-h AER was 0.96 (P = 0.0001). In the range of clinical proteinuria, r was 0.92 (P = 0.003, n = 7). In the range of microalbuminuria, r was 0.55 (P = 0.005, n = 26), and in the normal range, r was 0.59 (P < or = 0.0001, n = 90). Analysis of the untimed urine specimens from 218 black NIDDM subjects showed that 171 had A-to-C < 30 micrograms/mg, 38 had A-to-C 30-300 micrograms/mg, and 9 had A-to-C > 300 micrograms/mg. Data were grouped according to duration of NIDDM and the presence or absence of hypertension. None of the newly diagnosed NIDDM patients (< 1 year) (n = 40) had microalbuminuria. The frequency of microalbuminuria and clinical proteinuria increased with 1) duration of NIDDM 5-10 years (odds ratio [OR], 3.39; 95% CI 1.17-9.82),2) duration of NIDDM > 10 years (OR, 11.03; 95% CI 4.16-29.25), and 3) presence of hypertension (OR, 2.59; 95% CI I.20-5.61).


CONCLUSIONS
The A-to-C ratio obtained from an untimed morning urine specimen correlates with the AER from a 24-h collection. In black subjects with newly diagnosed NIDDM, microalbuminuria is not present to a significant degree. Duration of NIDDM > 5 years is associated with increased prevalence of microalbuminuria, and hypertension is associated with microalbuminuria and clinical proteinuria in this population.
Chaiken
R L
RL
State University of New York-Health Science Center at Brooklyn 11203, USA.
Khawaja
R
R
Bard
M
M
Eckert-Norton
M
M
Banerji
M A
MA
Lebovitz
H E
HE
D000328:Adult; D001741:Black or African American; D000419:Albuminuria; D044383:Black People; D001794:Blood Pressure; D015331:Cohort Studies; D003404:Creatinine / Q000652:urine; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000503:physiopathology / Q000652:urine*; D003925:Diabetic Angiopathies / Q000652:urine; D003928:Diabetic Nephropathies / Q000175:diagnosis / Q000517:prevention & control*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006766:Hospitals, County; D006801:Humans; D006973:Hypertension / Q000652:urine; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D008991:Monitoring, Physiologic; D009519:New York City; D010044:Outpatient Clinics, Hospital; D012044:Regression Analysis; D014280:Triglycerides / Q000097:blood
D003404:Creatinine; D006442:Glycated Hemoglobin; D014280:Triglycerides