[A study comparing the prevalence of urinary albumin excretion and microalbuminuria in pre-diabetes subjects].
OBJECTIVE
To investigate the difference in risks for vascular diseases by comparing urinary albumin excretion (UAE) and prevalence of microalbuminuria (MAU) in subjects with various types of glucose tolerance including normal glucose tolerance (NGT), isolated impaired fasting glucose (I-IFG), isolated impaired glucose tolerance (I-IGT), impaired glucose tolerance combined with impaired fasting glucose (IGT/IFG) and newly diagnosed type 2 diabetes mellitus (T2 DM).


METHODS
A total of 2934 subjects recruited in the study were divided into 5 groups based on 75 g oral glucose tolerance test (OGTT) results, NGT 1332 cases, I-IFG 186, I-IGT 470, IGT/IFG 236 and newly diagnosed T2 DM 710 cases respectively. UAE was detected with radioimmunoassay. MAU was defined if UAE was between 20 - 200 micro g/min.


RESULTS
(1) UAE [median (25%, 75%)] in the newly diagnosed T2 DM [8.50 (4.89 - 15.95) micro g/min], IGT/IFG group [6.93 (4.85 - 10.89) micro g/min], and I-IGT group [6.51 (4.09 - 10.74) micro g/min] was all higher than that in I-IFG group [5.56 (3.70 - 9.23) micro g/min, P < 0.01, respectively)], but UAE was comparable between I-IFG group and NGT group [5.26 (3.50 - 8.12) micro g/min], P > 0.05. The prevalence of MAU was 20.7% in newly diagnosed T2 DM group, 13.1% in IGT/IFG group, 11.1% in I-IGT group, 5.8% in I-IFG group and 5.6% in NGT group, showing the same trend as UAE in various types of glucose tolerance. (2) Multiple linear regression analysis showed that UAE was positively correlated with OGTT 2h blood glucose (BG), diastolic blood pressure (DBP) and body mass index (BMI). Logistic regression analysis showed that the risk factors for MAU were elevation of BMI, DBP and OGTT 2 h BG, while high-density lipoprotein cholesterol was a protective factor.


CONCLUSIONS
UAE and the prevalence of MAU were higher in I-IGT subjects than that in NGT subjects, and much higher in IGT/IFG and newly diagnosed T 2 DM subjects, but there were no significant difference of UAE between I-IFG and NGT subjects. It is suggested that in early stage of abnormal glucose tolerance, postprandial hyperglycemia might be a more important risk factor for UAE and prevalence of MAU than isolated fasting hyperglycemia.
Wang
Xian-ling
XL
Department of Endocrinology, Chinese PLA General Hospital, Beijing 100853, China.
Lu
Ju-ming
JM
Pan
Chang-yu
CY
Tian
Hui
H
D000328:Adult; D000419:Albuminuria / Q000453:epidemiology* / Q000209:etiology; D003928:Diabetic Nephropathies / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors