Albuminuria in Australian Aboriginal people: prevalence and associations with components of the metabolic syndrome.
OBJECTIVE
To examine the prevalence and associations with the metabolic syndrome of albuminuria among Australian Aboriginal people.


METHODS
Early-morning urine specimens were collected as part of community-based risk factor surveys assessing the prevalence of diabetes and cardiovascular disease in eight remote communities, with a sample size of 1,075 people. Microalbuminuria was defined as urinary albumin : creatinine ratio 3.4-33.9 mg/mmol, macroalbuminuria as albumin: creatinine ratio equal to or greater than 34 mg/mmol.


RESULTS
There were high prevalences of microalbuminuria (men 22.2 %, women 26.9 %) and of macroalbuminuria (men 10.4%, women 13.5%). There were highly statistically significant linear associations of microalbuminuria and macroalbuminuria with increasing number of coexisting components of the metabolic syndrome (hypertension, glucose intolerance, dyslipidaemia, insulin resistance, abdominal obesity): among people with zero, one, two and three to five of these conditions, respectively, prevalence of microalbuminuria was 16%, 20%, 36% and 32% (p < 0.001); prevalence of macroalbuminuria was 2%, 6%, 12% and 32% (p < 0.001). There were independent associations of microalbuminuria with hypertension (odds ratio, 95% confidence interval = 2.36, 1.63-3.42) and diabetes (2.10, 1.28-3.45): macroalbuminuria was independently associated with hypertension (6.39, 3.93-10.4), diabetes (3.49, 1.93-6.28) and abdominal obesity (4.56, 2.40-8.64) and had a weaker association with insulin resistance (1.99, 1.12-3.54). Dyslipidaemia and impaired glucose tolerance were neither independently associated with microalbuminuria or macroalbuminuria, nor was insulin resistance or abdominal obesity independently associated with microalbuminuria.


CONCLUSIONS
There was a strong clustering of albuminuria with components of the metabolic syndrome. Diabetes, hypertension and abdominal obesity are major contributors to high rates of albuminuria among Australian Aboriginal people.
Rowley
K G
KG
The University of Melbourne, Department of Medicine, St Vincent's Hospital, Fitzroy, VIC, Australia.
Iser
D M
DM
Best
J D
JD
O'Dea
K
K
Leonard
D
D
McDermott
R
R
D000293:Adolescent; D000328:Adult; D000375:Aging; D000419:Albuminuria / Q000150:complications / Q000453:epidemiology*; D001315:Australia / Q000453:epidemiology; D015992:Body Mass Index; D003404:Creatinine / Q000652:urine; D005260:Female; D018149:Glucose Intolerance; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications / Q000453:epidemiology* / Q000652:urine; D006973:Hypertension / Q000150:complications / Q000453:epidemiology* / Q000652:urine; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000453:epidemiology* / Q000652:urine; D016017:Odds Ratio; D014552:Urinary Tract Infections / Q000453:epidemiology
D003404:Creatinine