Screening for Nephropathy in Diabetes Mellitus: Is Micral-Test Valid among All Diabetics?
Background. Using Micral-test (MT) for screening microalbuminuria (MA) among type 2 diabetics (T2D) is helpful. We aimed at determining prevalence of MA and at describing the MT validity. Methods. We studied 182 T2D followed up in family medicine. Two 24-hour urinary quantitative assays of MA had been used as a gold standard. Results. Prevalence of MA was 23%, CI 95%: 16.9-29.1. MT validity was 77% for sensitivity, 88% for negative predictive value, and 0.2 for Kappa coefficient (p = 0.001). Among subjects having a blood pressure ≥130/80 mmHg, having a CHT/HDL ratio ≥ 3, being a T2D for more than 5 years, and being women, negative predictive values were, respectively, 91%, 89%, 95%, and 91%. The area under the ROC curve was 0.81 in men (p = 0.008) and 0.80 when diabetes duration exceeds 5 years (p = 0.001). The MA value at 100% Sp for MT was 35 mg/L. Conclusion. The use of MT in primary healthcare for yearly screening for MA in T2D must be accentuated especially when diabetes duration exceeds 5 years or when associated with other cardiovascular risks.
Stah Jabeur Primary Health Center, Monastir Health Group, 5000 Monastir, Tunisia.
Koubaa
K
Afifa
Department of Preventive Medicine and Epidemiology, Faculty of Medicine, Monastir, Tunisia.
Sriha
S
Belguith Asma
Primary Health Center, Monastir Health Group, Monastir, Tunisia.
Harzallah
H
Nabil
Department of Pathology, Monastir, Tunisia.
Bellaleh
B
Ahlem
C2 Primary Health Center, Monastir Health Group, Monastir, Tunisia.
Sahtout
S
Mounira
Stah Jabeur Primary Health Center, Monastir Health Group, 5000 Monastir, Tunisia.
Younes
Y
Kawthar
Biochemistry Laboratory, Faculty of Pharmacy, Monastir, Tunisia.
Triki
T
Sonia
Biochemistry Laboratory, Faculty of Pharmacy, Monastir, Tunisia.
Hellara
H
Ilhem
Biochemistry Laboratory, Faculty of Pharmacy, Monastir, Tunisia.
Neffati
N
Fadoua
Biochemistry Laboratory, Faculty of Pharmacy, Monastir, Tunisia.
Najjar
N
Fadhel
Department of Preventive Medicine and Epidemiology, Faculty of Medicine, Monastir, Tunisia.
Soltani
S
Mohamed