title: Usefulness of microalbuminuria in patients with the metabolic syndrome to predict subclinical atherosclerosis and cardiovascular disease outcomes.
abstract: The clinical implications of microalbuminuria (MA) in nondiabetic persons with the metabolic syndrome (MS) are largely unknown. The present post hoc analysis of the Multiethnic Study of Atherosclerosis (MESA) included 5,809 nondiabetic persons with no history of cardiovascular disease aged 45 to 84 years. The study population was divided according to the presence or absence of MS and MA into 4 study groups: no MS and no MA, MA only, MS only, and MS plus MA. The measurements included markers of systemic inflammation, subclinical atherosclerosis, left ventricular mass index, composite and individual cardiovascular end points, and all-cause mortality. Prospective and cross-sectional analyses were performed to ascertain the association of study groups with these covariates. The MS plus MA group showed a consistently stronger association with the markers of systemic inflammation, subclinical atherosclerosis, and most clinical end points compared to the other study groups. In conclusion, stratification by MA can help identify a high-risk subset of nondiabetic patients with the MS.
authors.affiliation: Division of Internal Medicine, Wayne State University, Detroit, Michigan, USA. lafonso@med.wayne.edu
authors.forename: Luis
authors.initials: L
authors.lastname: Afonso
authors.forename: Pawan
authors.initials: P
authors.lastname: Hari
authors.forename: Ashok
authors.initials: A
authors.lastname: Kondur
authors.forename: Vikas
authors.initials: V
authors.lastname: Veeranna
authors.forename: Palaniappan
authors.initials: P
authors.lastname: Manickam
authors.forename: Mengistu
authors.initials: M
authors.lastname: Simegn
authors.forename: Sony
authors.initials: S
authors.lastname: Jacob
authors.forename: Brian
authors.initials: B
authors.lastname: Ference
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000652:urine*; D050197:Atherosclerosis / Q000150:complications / Q000652:urine*; D002318:Cardiovascular Diseases / Q000150:complications / Q000652:urine*; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000652:urine*; D008875:Middle Aged; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors