Microalbuminuria presents the same vascular risk as overt CVD in type 2 diabetes.
OBJECTIVE
We attempted to assess whether microalbuminuria conferred the same cardiovascular risk as overt CVD in type 2 diabetic patients.


METHODS
A prospective cohort study including 436 type 2 diabetic patients (64.8+/-9.2 years old) without proteinuria, with follow-up until any cardiovascular event occurred, was performed. Patients were classified into four groups: group 0, non baseline CVD and normoalbuminuria; group 1, non baseline CVD and microalbuminuria; group 2, baseline CVD and normoalbuminuria; group 3, baseline CVD and microalbuminuria. Cox's multivariate regression models were used to assess the risk ratio (RR) associated with each variable.


RESULTS
The median follow-up time was 7.6 years. Incidence rates of cardiovascular events per 1000 patient-years increased from groups 0 to 3 (23.8, 63.4, 74.1, 85.6; p<0.0001). Multivariate RR for incident CVD in groups 1, 2 and 3 in relation to group 0 were 2.8 (95% confidence interval (CI) 1.7-4.6; p<0.0001), 2.7 (95% CI 1.6-4.6; p<0.0001) and 2.9 (95% CI 1.6-5.4; p=0.001), respectively. No significant differences were seen between groups 1 and 2.


CONCLUSIONS
We suggest that patients with microalbuminuria are at very high vascular risk and should share the same objectives of a vascular risk-factor control as patients with overt CVD.
Gimeno-Orna
José Antonio
JA
Department of Internal Medicine, Alcañiz Hospital, Teruel, Spain. jagimeno@salud.aragon.es
Molinero-Herguedas
Edmundo
E
Sánchez-Vaño
Raquel
R
Lou-Arnal
Luis M
LM
Boned-Juliani
Beatriz
B
Castro-Alonso
Francisco J
FJ
D000368:Aged; D000419:Albuminuria / Q000145:classification / Q000453:epidemiology*; D015415:Biomarkers / Q000652:urine; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000652:urine; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000652:urine*; D003925:Diabetic Angiopathies / Q000453:epidemiology* / Q000652:urine; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D012016:Reference Values; D012307:Risk Factors
D015415:Biomarkers