title: Prevalence and determinants of albuminuria in a cohort of diabetic patients in Lebanon.
abstract: OBJECTIVE
  Few data are available on the extent of albuminuria in diabetic populations in the Middle East generally and in Lebanon specifically. We conducted this study to determine the prevalence of albuminuria and its major risk factors in a cohort of diabetic patients in Lebanon.
  
  
  METHODS
  Diabetic patients followed in the outpatient department at the American University of Beirut Medical Center (AUBMC) were included in a prospective observational study. AUBMC is a tertiary referral center and the outpatient department typically handles patients of low socioeconomic status with advanced disease. Patients were classified according to their urinary albumin-to-creatinine ratio (ACR) as having normoalbuminuria (ACR<30 mg/g creatinine), microalbuminuria (ACR=30 to <300 mg/g creatinine), or macroalbuminuria (ACR > or =300 mg/g creatinine). The three groups were compared to analyze the association between albuminuria and its risk factors. In addition, independent predictors of albuminuria were determined using multivariate logistic regression and presented as an odds ratio.
  
  
  RESULTS
  Microalbuminuria and macroalbuminuria were present in 33.3% and 12.7% of 222 patients (mean age 56.4 years, mean deviation of diabetes 8.6 years, 58.7% women, 43.8% obese), respectively. Factors significantly associated with microalbuminuria included glycemic control, insulin use, and total and LDL cholesterol. Those associated with macroalbuminuria included in addition to glycemic control and insulin use, duration of diabetes, hypertension, elevated mean arterial pressure (MAP), and presence of neuropathy, retinopathy and peripheral vascular disease by bivariate analysis. Only glycemic control was an independent risk factor for both in addition to MAP and retinopathy for macroalbuminuria by multivariate analysis.
  
  
  CONCLUSIONS
  Albuminuria is highly prevalent among this cohort of diabetic patients in Lebanon. Both glycemic control and blood pressure need to be better targeted in its management.
authors.affiliation: Department of Internal Medicine, Endocrinology, American University of Beirut, Beirut, Lebanon.
authors.forename: Nadine
authors.initials: N
authors.lastname: Taleb
authors.forename: Haytham
authors.initials: H
authors.lastname: Salti
authors.forename: Mona
authors.initials: M
authors.lastname: Al-Mokaddam
authors.forename: Marie
authors.initials: M
authors.lastname: Merheb
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Salti
authors.forename: Mona
authors.initials: M
authors.lastname: Nasrallah
mesh_terms: D000419:Albuminuria / Q000097:blood / Q000453:epidemiology*; D001794:Blood Pressure; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003928:Diabetic Nephropathies / Q000453:epidemiology / Q000517:prevention & control; D006801:Humans; D007861:Lebanon / Q000453:epidemiology; D016015:Logistic Models; D009765:Obesity / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL