title: Factors affecting levels of urinary albumin excretion in the general population of Spain: the Di@bet.es study.
abstract: The present study was undertaken to examine the prevalence of urinary ACR (albumin/creatinine ratio) >30 mg/g and the associated clinical and environmental factors in a representative sample of the population of Spain. Di@bet.es study is a national, cross-sectional population-based survey conducted in 2009-2010. Clinical, metabolic, socio-demographic, anthropometric data and information about lifestyle habit were collected. Those subjects without KDM (known diabetes mellitus) were given an OGTT (oral glucose tolerance test). Albumin and creatinine were measured in a urinary sample and ACR was calculated. The population prevalence of ACR >30 mg/g was 7.65% (adjusted for sex and age). The prevalence of ACR >30 mg/g increased with age (P<0.001). Subjects with carbohydrate metabolism disorders had a greater prevalence of ACR >30 mg/g but after being adjusted for age, sex and hypertension, was significant only in those subjects with UKDM (unknown diabetes mellitus) {OR (odd ratio), 2.07 [95% CI (confidence interval), 1.38-3.09]; P<0.001] and KDM [OR, 3.55 (95% CI, 2.63-4.80); P<0.001]. Prevalence of ACR >30 mg/g was associated with hypertension [OR, 1.48 (95% CI, 1.12-1.95); P=0.001], HOMA-IR (homoeostasis model assessment of insulin resistance) [OR, 1.47 (95% CI, 1.13-1.92); P≤0.01], metabolic syndrome [OR, 2.17 (95% CI, 1.72-2.72); P<0.001], smoking [OR, 1.40 (95% CI, 1.06-1.83); P≤0.05], physical activity [OR, 0.68 (95% CI, 0.54-0.88); P≤0.01] and consumption of fish [OR, 0.38 (95% CI, 0.18-0.78); P≤0.01]. This is the first study that reports the prevalence of ACR >30 mg/g in the Spanish population. The association between clinical variables and other potentially modifiable environmental variables contribute jointly, and sometimes interactively, to the explanation of prevalence of ACR >30 mg/g. Many of these risk factors are susceptible to intervention.
authors.affiliation: Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Spain.
authors.forename: Carolina
authors.initials: C
authors.lastname: Gutiérrez-Repiso
authors.forename: Gemma
authors.initials: G
authors.lastname: Rojo-Martínez
authors.forename: Federico
authors.initials: F
authors.lastname: Soriguer
authors.forename: Eduardo
authors.initials: E
authors.lastname: García-Fuentes
authors.forename: Joan
authors.initials: J
authors.lastname: Vendrell
authors.forename: José A
authors.initials: JA
authors.lastname: Vázquez
authors.forename: Sergio
authors.initials: S
authors.lastname: Valdés
authors.forename: Inés
authors.initials: I
authors.lastname: Urrutia
authors.forename: Manuel
authors.initials: M
authors.lastname: Serrano-Rios
authors.forename: Gemma
authors.initials: G
authors.lastname: Pascual-Manich
authors.forename: Emilio
authors.initials: E
authors.lastname: Ortega
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Mora-Peces
authors.forename: Edelmiro
authors.initials: E
authors.lastname: Menéndez
authors.forename: M Teresa
authors.initials: MT
authors.lastname: Martínez-Larrad
authors.forename: Alfonso
authors.initials: A
authors.lastname: López-Alba
authors.forename: Galder
authors.initials: G
authors.lastname: Gutiérrez
authors.forename: Ramón
authors.initials: R
authors.lastname: Gomis
authors.forename: Albert
authors.initials: A
authors.lastname: Goday
authors.forename: Juan
authors.initials: J
authors.lastname: Girbés
authors.forename: Sonia
authors.initials: S
authors.lastname: Gaztambide
authors.forename: Josep
authors.initials: J
authors.lastname: Franch
authors.forename: Elías
authors.initials: E
authors.lastname: Delgado
authors.forename: Miguel
authors.initials: M
authors.lastname: Catalá
authors.forename: Conxa
authors.initials: C
authors.lastname: Castell
authors.forename: Luis
authors.initials: L
authors.lastname: Castaño
authors.forename: Roser
authors.initials: R
authors.lastname: Casamitjana
authors.forename: Rafael
authors.initials: R
authors.lastname: Carmena
authors.forename: Alfonso
authors.initials: A
authors.lastname: Calle-Pascual
authors.forename: Elena
authors.initials: E
authors.lastname: Bordiú
authors.forename: Anna
authors.initials: A
authors.lastname: Bosch-Comas
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000453:epidemiology / Q000209:etiology* / Q000652:urine; D000704:Analysis of Variance; D015415:Biomarkers / Q000652:urine; D003404:Creatinine / Q000652:urine; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D017678:Sex Distribution; D013030:Spain / Q000453:epidemiology; D055815:Young Adult
chemical_list: D015415:Biomarkers; D003404:Creatinine