Prevalence of albuminuria and cardiovascular risk profile in a referred cohort of patients with type 2 diabetes: an Asian perspective.
BACKGROUND
Microalbuminuria (MA) is a risk marker for diabetic nephropathy and cardiovascular (CV) disease (CVD) in patients with diabetes. This study aimed to describe the prevalence of albuminuria, CV risk factors, and treatments for renal and CV protection in an Asian population with type 2 diabetes.


METHODS
This cross-sectional study conducted in eight Asian countries enrolled normotensive/hypertensive adults with type 2 diabetes without known proteinuria and/or non-diabetic kidney disease. Exclusion criteria were type 1 diabetes, menstruation, pregnancy, and acute fever. A single random urinary albumin/creatinine test was carried out in all patients.


RESULTS
Of 8,561 patients, 14% had diabetic retinopathy, and 17% and 21% had history of CV disease and smoking, respectively. Normoalbuminuria was seen in 44%, MA in 44%, and macroalbuminuria in 12%. Target glycosylated hemoglobin (HbA1c) (<7%) was reached in only 37% of 3,834 patients with available values. Diabetes was managed by diet alone in 6%, while others received oral hypoglycemic drugs and/or insulin. In total, 75% did not reach target blood pressure (BP) of <or=130/80 mm Hg. Antihypertensive drugs were prescribed to 52%, with the number of drugs increasing as the level of systolic BP increased. Drugs blocking the renin-angiotensin system were most commonly prescribed, followed by calcium channel blockers. Lipid-lowering drugs and anticoagulant/antiplatelet agents were used in about 30% and 25% of patients, respectively.


CONCLUSIONS
Asian patients with type 2 diabetes had a high prevalence of MA and reduced kidney function. Furthermore, BP and HbA1c control was only achieved in a minority of patients. Aggressive risk management by administration of reno- and cardioprotective treatments is urgently needed.
Pan
C Y
CY
Chinese PLA General Hospital, Beijing, People's Republic of China. panchy301@yahoo.com.cn
Ho
L T
LT
Soegondo
S
S
Prodjosudjadi
W
W
Suwanwalaikorn
S
S
Lim
S C
SC
Chan
T M
TM
Chow
K W Steven
KW
Thoenes
M
M
Choi
D S
DS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000453:epidemiology* / Q000208:ethnology / Q000503:physiopathology / Q000652:urine; D001208:Asia / Q000453:epidemiology; D001794:Blood Pressure / Q000502:physiology; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000208:ethnology / Q000503:physiopathology / Q000652:urine; D015331:Cohort Studies; D003404:Creatinine / Q000652:urine; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000208:ethnology / Q000503:physiopathology / Q000652:urine; D003928:Diabetic Nephropathies / Q000453:epidemiology / Q000208:ethnology / Q000503:physiopathology / Q000652:urine; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007391:International Cooperation; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors
D003404:Creatinine; D006442:Glycated Hemoglobin