title: Waist circumference and the metabolic syndrome predict the development of elevated albuminuria in non-diabetic subjects: the DESIR Study.
abstract: OBJECTIVE
  Metabolic determinants of microalbuminuria remain poorly understood in non-diabetic individuals and particularly in women. We investigated in both sexes whether an elevated waist circumference (WC) or the presence of the metabolic syndrome (MetS) predict the development of elevated albuminuria at 6 years.
  
  
  METHODS
  We studied 2738 subjects from the DESIR cohort without microalbuminuria or diabetes at baseline and who were followed up for 6 years.
  
  
  RESULTS
  At 6 years, 254 individuals [9.3%; 95% confidence interval (CI) 8.2-10.4%] had developed elevated albuminuria (> or = 20 mg/l), which was significantly and positively associated with WC and blood pressure, but not with fasting glucose, lipids or body mass index in either sex. In both sexes, subjects with a high WC or with MetS at baseline were more likely to develop elevated albuminuria at 6 years compared with those with a normal WC or absence of MetS. In multivariate logistic analysis, WC as a continuous variable or a WC of 94 cm or greater for men and a WC greater than 88 cm for women were predictive of the development of elevated albuminuria, after adjusting for age, hypertension, the use of angiotensin-converting enzyme inhibitors, fibrinogen and glycaemia. MetS was a risk factor for elevated albuminuria in men (odds ratio 1.87; 95% CI 1.25-2.81), with differences according to the MetS definition.
  
  
  CONCLUSIONS
  Abdominal adiposity is related to the development of elevated albuminuria in both sexes, suggesting that the measurement of WC may improve the identification of non-diabetic individuals at risk of developing microalbuminuria and emphasizing the interest of screening for albuminuria among those with MetS.
authors: Department of Diabetology-Endocrinology, CRNH, Hospital Edouard Herriot, INSERM U 449, Lyon, France. fabrice.bonnet@chu-lyon.fr
authors: Fabrice
authors: F
authors: Bonnet
authors: Michel
authors: M
authors: Marre
authors: Jean-Michel
authors: JM
authors: Halimi
authors: Bénédicte
authors: B
authors: Stengel
authors: Céline
authors: C
authors: Lange
authors: Martine
authors: M
authors: Laville
authors: Jean
authors: J
authors: Tichet
authors: Beverley
authors: B
authors: Balkau