Microalbuminuria is positively associated with usual dietary saturated fat intake and negatively associated with usual dietary protein intake in people with insulin-dependent diabetes mellitus.
Microalbuminuria has a cumulative incidence of > 30% in persons by 25 y duration of insulin-dependent diabetes mellitus (IDDM) and is a strong predictor of renal disease and mortality. Although improved glycemic control, maintenance of normal blood pressure, and use of angiotensin-converting enzyme inhibitors are important strategies to avoid developing microalbuminuria, dietary macronutrient intake may also play a role. A cross-sectional population-based study of Tasmanian adults with IDDM and no previous diagnosis of microalbuminuria was conducted by measuring usual dietary macronutrient intake with a food-frequency questionnaire and defining microalbuminuria as an average urinary albumin excretion rate between 20 and 200 micrograms albumin/min in at least two of three timed overnight urine collections. After sex, age, duration of diabetes, daily number of insulin injections, body mass index, glycated hemoglobin, serum high-density-lipoprotein cholesterol, frequency of exercise, and smoking status were adjusted for, the adjusted odds ratio for microalbuminuria for the highest quintile of energy-adjusted usual saturated fat intake compared with the lowest quintile was 4.9 (95% CI: 1.2, 20.0; P = 0.03). The adjusted odds ratio for microalbuminuria for the highest quintile of energy-adjusted usual protein intake compared with the lowest quintile was 0.10 (95% CI: 0.02, 0.56; P = 0.01). There was no significant association between microalbuminuria and energy-adjusted carbohydrate intake, energy-adjusted monounsaturated fat intake, or energy-adjusted polyunsaturated fat intake.
Riley
M D
MD
Menzies Centre for Population Health Research, University of Tasmania, Hobart, Australia. mdr@utas.edu.au
Dwyer
T
T
D000328:Adult; D000419:Albuminuria / Q000453:epidemiology / Q000209:etiology / Q000652:urine*; D015331:Cohort Studies; D016001:Confidence Intervals; D015986:Confounding Factors, Epidemiologic; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000503:physiopathology / Q000652:urine; D003928:Diabetic Nephropathies / Q000453:epidemiology / Q000209:etiology / Q000652:urine*; D004041:Dietary Fats / Q000008:administration & dosage / Q000009:adverse effects*; D004044:Dietary Proteins / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D012044:Regression Analysis; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013648:Tasmania / Q000453:epidemiology
D004041:Dietary Fats; D004044:Dietary Proteins