title: Independent correlates of urinary albumin excretion within the normoalbuminuric range in patients with type 2 diabetes: The Renal Insufficiency And Cardiovascular Events (RIACE) Italian Multicentre Study.
abstract: OBJECTIVE
  Within the normoalbuminuric range, low albuminuria (LA, 10-29 mg/24 h) is associated with higher adverse cardiovascular and renal outcomes than normal albuminuria (NA, <10 mg/24 h). This cross-sectional analysis of the cohort from the Renal Insufficiency And Cardiovascular Events (RIACE) Italian Multicentre Study was aimed at assessing the independent correlates of LA versus NA in patients with type 2 diabetes.
  
  
  METHODS
  This analysis involved 11,538 normoalbuminuric patients (73.2 % of the entire RIACE cohort): 6023 (52.2 %) with NA and 5515 (47.8 %) with LA. Binary logistic regression analysis with backward conditional variable selection was applied to assess the independent correlates of LA versus NA.
  
  
  RESULTS
  Compared with NA subjects, LA patients were more frequently males, older and with family history of hypertension, had longer diabetes duration, lower HDL cholesterol, and higher haemoglobin (Hb) A1c, triglycerides, and blood pressure (BP), use of anti-hyperglycaemic and anti-hypertensive drugs, and prevalence of metabolic syndrome, retinopathy, chronic kidney disease, any cardiovascular disease, myocardial infarction, and coronary and peripheral events. Men with LA were also more frequently current or former smokers and had higher body mass index, waist circumference, and non-HDL cholesterol. Independent correlates of LA were age (OR 1.018), family history of hypertension (OR 1.321), smoking status (former, OR 1.158; current, OR 1.237), HbA1c (OR 1.062), waist circumference (OR 1.050), triglycerides (OR 1.001), and diastolic BP (OR 1.014), together with use of anti-hyperglycaemic and anti-hypertensive agents.
  
  
  CONCLUSIONS
  Several risk factors are associated with increased albuminuria within the normoalbuminuric range. As most of these factors are potentially modifiable, treating them aggressively might reduce the excess risk associated with LA.
  
  
  BACKGROUND
  NCT00715481; www.ClinicalTrials.gov .
authors.affiliation: Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Penno
authors.affiliation: Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Solini
authors.affiliation: Division of Endocrinology and Metabolic Diseases, University of Verona, Verona, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Zoppini
authors.affiliation: Diabetes Unit, University of Siena, Siena, Italy.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Fondelli
authors.affiliation: Endocrinology and Diabetes Unit, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Trevisan
authors.affiliation: Department of Clinical and Experimental Medicine, University of Padua, Padua, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Vedovato
authors.affiliation: Department of Clinical and Biological Sciences, University of Turin, Orbassano, Turin, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Cavalot
authors.affiliation: Department of Internal Medicine, University of Turin, Turin, Italy.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Gruden
authors.affiliation: Department of Medical Sciences, University of Foggia, Foggia, Italy.
authors.forename: Olga
authors.initials: O
authors.lastname: Lamacchia
authors.affiliation: Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Laviola
authors.affiliation: Diabetes Unit, IRCCS "Cà Granda - Ospedale Maggiore Policlinico" Foundation, Milan, Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Orsi
authors.affiliation: Department of Clinical and Molecular Medicine, "La Sapienza" University, Via di Grottarossa, 1035-1039, 00189, Rome, Italy. giuseppe.pugliese@uniroma1.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Pugliese
mesh_terms: D000368:Aged; D000419:Albuminuria / Q000453:epidemiology / Q000652:urine*; D001794:Blood Pressure; D015992:Body Mass Index; D008076:Cholesterol, HDL / Q000097:blood; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000652:urine*; D058065:Diabetic Cardiomyopathies / Q000453:epidemiology / Q000652:urine*; D003928:Diabetic Nephropathies / Q000453:epidemiology / Q000652:urine*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D014280:Triglycerides / Q000097:blood
chemical_list: D008076:Cholesterol, HDL; D006442:Glycated Hemoglobin; D014280:Triglycerides
keywords: Albumin excretion rate; Chronic kidney disease; Diabetic retinopathy; Type 2 diabetes; eGFR