title: A microalbuminuria threshold to predict the risk for the development of diabetic retinopathy in type 2 diabetes mellitus patients.
abstract: OBJECTIVE
  To test the hypothesis that a microalbuminuria (MA) threshold can help predict the risk for the development of diabetic retinopathy (DR) in type 2 diabetes mellitus (T2DM)_ patients.
  
  
  METHODS
  We conducted a cross-sectional study of 4739 subjects with T2DM and a prospective study of 297 subjects with T2DM in China respectively.
  
  
  METHODS
  Clinical and laboratory data were collected and biologic risk factors associated with any DR were analysed.
  
  
  RESULTS
  In the cross-sectional study, we found that MA was an independent risk factor for DR development; further, when the patients were divided into MA deciles, odds ratio (ORs) of DR for the patients in the sixth MA decile (10.7 mg/24 h) was 1.579-fold (1.161-2.147) compared to that for patients in the first MA decile. Furthermore, the OR of DR increased with a gradual increase in MA levels. Similarly, in the prospective study, during a mean follow-up of 4.5 years, we found that 51 patients (29.0%) of the 176 subjects with high MA level (10.7-30 mg/24 h) developed DR, while 17 patients (14.1%) of the 121 subjects with lower MA (<10.7 mg/24 h) developed DR, and the relative risk ratio of the development of DR is 2.13(95% CI, 1.58-3.62, P<0.001).
  
  
  CONCLUSIONS
  These data suggest that an MA threshold can predict the risk for the development of DR in type 2 diabetes mellitus, although it is still within the traditionally established normal range.
authors.affiliation: Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai Diabetes Institute, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai, China.
authors.forename: Haibing
authors.initials: H
authors.lastname: Chen
authors.forename: Zhi
authors.initials: Z
authors.lastname: Zheng
authors.forename: Yan
authors.initials: Y
authors.lastname: Huang
authors.forename: Kaifeng
authors.initials: K
authors.lastname: Guo
authors.forename: Junxi
authors.initials: J
authors.lastname: Lu
authors.forename: Lei
authors.initials: L
authors.lastname: Zhang
authors.forename: Haoyong
authors.initials: H
authors.lastname: Yu
authors.forename: Yuqian
authors.initials: Y
authors.lastname: Bao
authors.forename: Weiping
authors.initials: W
authors.lastname: Jia
mesh_terms: D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000150:complications / Q000652:urine; D002681:China; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000652:urine*; D003930:Diabetic Retinopathy / Q000209:etiology / Q000652:urine; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors