The association between urinary albumin excretion and ankle-brachial index in elderly Taiwanese patients with type 2 diabetes mellitus.
OBJECTIVE
this study examined the association between urinary albumin/creatinine ratio (ACR) and ankle-brachial index (ABI), or peripheral arterial disease (PAD), in elderly patients with type 2 diabetes mellitus (T2DM).


METHODS
a total of 290 (108 men, 182 women) T2DM, aged > or =65 (71.6 +/- 4.9) years were recruited. PAD was diagnosed by ABI<0.9, and ACR was divided into normoalbuminuria (<30.0 microg/mg), microalbuminuria (30.0-299.9 microg/mg), and macroalbuminuria (> or = 300.0 microg/mg).


RESULTS
patients with PAD (n = 45) had higher ln(ACR) than patients without: 4.48 +/- 1.48 versus 3.73 +/- 1.39 (P<0.01). For normoalbuminuria (n = 112), microalbuminuria (n = 152), and macroalbuminuria (n = 26), respective PAD prevalence was 8.0, 17.1 and 38.5% (P<0.001). The proportion of normoalbuminuria, microalbuminuria and macroalbuminuria in patients with PAD was 20.0, 57.8 and 22.2%, respectively; and 42.0, 51.4 and 6.5%, respectively, in patients without (P<0.001). Ln(ACR) was inversely correlated with ABI in all patients (gamma = -0.198, P<0.01) and in separate sexes (gamma = -0.211 for men and gamma = -0.181 for women). The multivariate-adjusted odds ratios for PAD for every 1 unit increment of ln(ACR) was 1.66 (1.17-2.34); and for microalbuminuria versus normoalbuminuria and macroalbuminuria versus normoalbuminuria were 2.54 (1.05-6.17) and 5.86 (1.76-19.52), respectively.


CONCLUSIONS
urinary ACR is not only associated with PAD, it is also significantly correlated with ABI in an inverse pattern in elderly Taiwanese with T2DM.
Tseng
Chin-Hsiao
CH
Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan. ccktsh@ms6.hinet.net
Chong
Choon-Khim
CK
Tseng
Ching-Ping
CP
Tai
Tong-Yuan
TY
D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D000842:Ankle / Q000098:blood supply; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination; D001916:Brachial Artery / Q000503:physiopathology; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D003925:Diabetic Angiopathies / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D003928:Diabetic Nephropathies / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D015994:Incidence; D007511:Ischemia / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D007866:Leg / Q000098:blood supply; D008297:Male; D012307:Risk Factors; D013223:Statistics as Topic; D013624:Taiwan; D018608:Ultrasonography, Doppler
D003404:Creatinine