Albuminuria in recent-onset type 2 diabetes: the Strong Heart Study.
OBJECTIVE
It is not known how frequently abnormal albumin excretion occurs in the initial years after the onset of type 2 diabetes and to what extent its occurrence is related to the severity of diabetes. We have used a prospective cohort study to examine this.


METHODS
A total of 782 participants from the Strong Heart Study who had normal glucose tolerance and normal albumin excretion (albumin-to-creatinine ratio <30 mg albumin/g creatinine) at baseline were assessed for diabetes and abnormal albumin excretion at a follow-up visit (interval 3.91 +/- 0.95 years, mean +/- SD). Logistic regression models were used to examine the associations.


RESULTS
Abnormal albumin excretion was detected in 52 (6.6%) and diabetes was determined to be present in 105 (13.4%) of the participants at the follow-up visit. In univariate analyses, abnormal albumin excretion was statistically significantly related to the baseline albumin-to-creatinine ratio, diastolic blood pressure, fasting insulin, and extent of American Indian heritage. Abnormal albumin excretion was much more prevalent in those with recent onset diabetes at the follow-up visit (18 vs. 5%, P < 0.001). In a logistic regression analysis, abnormal albumin excretion and diabetes remained strongly related (odds ratio 3.45, P < 0.001), and associations of abnormal albumin excretion with baseline albumin-to-creatinine ratio, blood pressure, and American Indian heritage also remained significant in a separate logistic regression analysis, including only those who developed diabetes. There was a strong association between abnormal albumin excretion and fasting glucose levels (<0.01) at the follow-up visit.


CONCLUSIONS
These data suggest that an appreciable percentage of individuals develop abnormal albumin excretion within the first few years after the onset of type 2 diabetes. Also, the severity of diabetes at onset appears to be a key risk factor for the early development of abnormal albumin excretion.
Sosenko
Jay M
JM
University of Miami School of Medicine, Miami, Florida, USA. jsosenko@med.miami.edu
Hu
Dongsheng
D
Welty
Tom
T
Howard
Barbara V
BV
Lee
Elisa
E
Robbins
David C
DC
D000368:Aged; D000419:Albuminuria / Q000453:epidemiology; D000704:Analysis of Variance; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D015992:Body Mass Index; D015331:Cohort Studies; D003404:Creatinine / Q000652:urine; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000652:urine*; D005260:Female; D006801:Humans; D007198:Indians, North American; D007328:Insulin / Q000097:blood; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D012727:Sex Characteristics; D018709:Statistics, Nonparametric; D013997:Time Factors; D014481:United States
D001786:Blood Glucose; D007328:Insulin; D003404:Creatinine