Increased urinary albumin excretion and its associations in the WHO Multinational Study of Vascular Disease in Diabetes.
OBJECTIVE
We aimed to determine variations in the prevalence of increased urinary albumin excretion, associated risk factors and complications in patients with diabetes participating in the WHO Multinational Study of Vascular Disease in Diabetes follow-up.


METHODS
Urinary albumin to urinary creatinine ratios were measured centrally in 2,033 of the 2,550 (79.7%) re-examined patients from eight centres in seven countries and the frequency of microalbuminuria and macroalbuminuria and their associations with risk factors and complications were examined.


RESULTS
Macroalbuminuria prevalence (overall 15.6%) varied tenfold (3-37%) among centres, was higher in American Indian and Asian centres and not clearly related to type of diabetes. Microalbuminuria (overall 19.7 %) varied less (12-31%). Increased albumin excretion was related overall to baseline fasting plasma glucose in the pooled group in whom it was measured and to increased arterial pressure, insulin use, coronary heart disease, lower extremity amputation, retinopathy and stroke in most centres.


CONCLUSIONS
Centres varied widely in the prevalence of increased albumin excretion but associations with risk factors and vascular complications were generally similar in most centres and in both major types of diabetes with ethnic and genetic differences probably contributing.
Bennett
P H
PH
Phoenix Epidemiology and Clinical Research Branch, NIDDK, Arizona, USA.
Lee
E T
ET
Lu
M
M
Keen
H
H
Fuller
J H
JH
D000419:Albuminuria / Q000453:epidemiology*; D000671:Amputation, Surgical; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D003327:Coronary Disease / Q000652:urine; D003404:Creatinine / Q000652:urine; D003925:Diabetic Angiopathies / Q000453:epidemiology*; D003930:Diabetic Retinopathy / Q000652:urine; D005215:Fasting; D005260:Female; D006801:Humans; D007198:Indians, North American; D007328:Insulin / Q000627:therapeutic use; D007391:International Cooperation; D016015:Logistic Models; D008297:Male; D012307:Risk Factors; D020521:Stroke / Q000652:urine; D014944:World Health Organization
D001786:Blood Glucose; D007328:Insulin; D003404:Creatinine