Is microalbuminuria an integrated risk marker for cardiovascular disease and insulin resistance in both men and women?
BACKGROUND
Microalbuminuria is associated with some cardiovascular risk factors. However, it is presently unclear whether microalbuminuria is associated with other cardiovascular risk factors and markers of insulin resistance in both men and women.


METHODS
The baseline parameters of the on-going prospective D.E.S.I.R. Study (Data from an Epidemiological Study on the Insulin Resistance syndrome) were analysed.


METHODS
The subjects (n = 3878, age 30-64) had a medical and biological checkup including arterial pressure, ECG, lipids, haematocrit, leukocyte count, insulin and urinary albumin concentration.


RESULTS
Arterial pressure was significantly higher in microalbuminuric than in normoalbuminuric men and women. The heart rate and the prevalence of smoking were higher in microalbuminuric than in normoalbuminuric men, but not in women. Total- and LDL-cholesterol, triglycerides, apolipoprotein-B, leukocyte count, uric acid, haematocrit, haemoglobin and red cell volume were greater in microalbuminuric than in normoalbuminuric men. Total- and HDL-cholesterol were lower whereas triglycerides and uric acid were significantly greater in microalbuminuric than in normoalbuminuric women. The 9-year calculated absolute cardiovascular risk was higher in microalbuminuric than in normoalbuminuric men (4.18% vs. 2.79%, respectively, P < 0.0001) but was similar in women (0.75% vs. 0.69%, respectively, NS). Fasting blood glucose and insulin were higher in microalbuminuric than in normoalbuminuric men, but not in women. A multiple regression showed that microalbuminuria was associated with systolic arterial pressure, fasting glucose, leukocyte count and haematocrit in men, and with systolic arterial pressure and triglycerides in women.


CONCLUSIONS
Microalbuminuria is associated with most cardiovascular risk factors and markers of insulin resistance in men, but no consistent association is observed in women. The determinants of microalbuminuria appear different in men and women, suggesting a different pathophysiology and perhaps significance of microalbuminuria in men and women.
Halimi
J M
JM
Centre de Recherche Clinique, Tours University and Nephrology Department, CHU Tours, France.
Forhan
A
A
Balkau
B
B
Novak
M
M
Wilpart
E
E
Tichet
J
J
Marre
M
M
D000328:Adult; D000419:Albuminuria / Q000097:blood / Q000150:complications* / Q000453:epidemiology; D000428:Alcohol Drinking / Q000009:adverse effects / Q000652:urine; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000150:complications* / Q000652:urine; D002784:Cholesterol / Q000097:blood; D003404:Creatinine / Q000097:blood / Q000652:urine; D004912:Erythrocytes / Q000737:chemistry; D004967:Estrogens / Q000627:therapeutic use; D015444:Exercise / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy / Q000652:urine; D007328:Insulin / Q000097:blood / Q000378:metabolism; D007333:Insulin Resistance / Q000502:physiology*; D000078790:Insulin Secretion; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017698:Postmenopause / Q000652:urine; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects / Q000652:urine; D014280:Triglycerides / Q000097:blood; D016387:Women's Health
D000806:Angiotensin-Converting Enzyme Inhibitors; D015415:Biomarkers; D001786:Blood Glucose; D004967:Estrogens; D007328:Insulin; D014280:Triglycerides; D002784:Cholesterol; D003404:Creatinine