title: Microalbuminuria presents the same vascular risk as overt CVD in type 2 diabetes.
abstract: 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.
authors.affiliation: Department of Internal Medicine, Alcañiz Hospital, Teruel, Spain. jagimeno@salud.aragon.es
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Gimeno-Orna
authors.forename: Edmundo
authors.initials: E
authors.lastname: Molinero-Herguedas
authors.forename: Raquel
authors.initials: R
authors.lastname: Sánchez-Vaño
authors.forename: Luis M
authors.initials: LM
authors.lastname: Lou-Arnal
authors.forename: Beatriz
authors.initials: B
authors.lastname: Boned-Juliani
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Castro-Alonso
mesh_terms: 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
chemical_list: D015415:Biomarkers