Rossi, Maria C. E., Nicolucci, Antonio, Pellegrini, Fabio, Comaschi, Marco, Ceriello, Antonio, Cucinotta, Domenico, Giorda, Carlo, Valentini, Umberto, Vespasiani, Giacomo and De Cosmo, Salvatore (2008) Identifying patients with type 2 diabetes at high risk of microalbuminuria : results of the DEMAND (Developing Education on Microalbuminuria for Awareness of reNal and cardiovascular risk in Diabetes) Study. Nephrology, Dialysis, Transplantation, Volume 23 (Number 4). pp. 1278-1284. doi:10.1093/ndt/gfm798 ISSN 0931-0509.

Research output not available from this repository.

Request-a-Copy directly from author or use local Library Get it For Me service.

Request Changes to record.

Abstract

Background. We evaluated to what extent the presence of risk factors and their interactions increased the likelihood of microalbuminuria (MAU) among individuals with type 2 diabetes.

Methods. Fifty-five Italian diabetes outpatient clinics enrolled a sample of patients with type 2 diabetes, without urinary infections and overt diabetic nephropathy. A morning spot urine sample was collected to centrally determine the urinary albumincreatinine ratio (ACR). A tree-based regression technique (RECPAM) and multivariate analyses were performed to investigate interaction between correlates of MAU.

Results. Of the 1841 patients recruited, 228 (12.4%) were excluded due to the presence of urinary infections and 56 (3.5) for the presence of macroalbuminuria. Overall, the prevalence of MAU (ACR 30-299 mg/g) was of 19.1%. The RECPAM algorithm led to the identification of seven classes showing a marked difference in the likelihood of MAU. Non-smoker patients with HbA1c < 7% and waist circumference <= 102 cm showed the lowest prevalence of MAU (7.5%), and represented the reference class. Patients with retinopathy, waist circumference > 98 cm and HbA1c > 8% showed the highest likelihood of MAU (odds ratio 13.7; 95% confidence intervals 6.8-27.6). In the other classes identified, the risk of MAU ranged between 3 and 5. Age, systolic blood pressure, HDL cholesterol levels and diabetes treatment represented additional, global correlates of MAU.

Conclusions. The likelihood of MAU is strongly related to the interaction between diabetes severity, smoking habits and several components of the metabolic syndrome. In particular, abdominal obesity, elevated blood pressure levels and low HDL cholesterol levels substantially increase the risk of MAU. It is of primary importance to monitor MAU in high-risk individuals and aggressively intervene on modifiable risk factors.

Item Type:	Journal Article
Subjects:	R Medicine > RC Internal medicine
Divisions:	Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Cardiovascular system -- Diseases -- Prevention, Cardiovascular system -- Diseases -- Risk factors, Albuminuria, Recursive partitioning -- Computer programs, Survival analysis (Biometry) -- Computer programs, Non-insulin-dependent diabetes -- Complications, Diabetic angiopathies
Journal or Publication Title:	Nephrology, Dialysis, Transplantation
Publisher:	Oxford University Press
ISSN:	0931-0509
Official Date:	April 2008
Dates:	Date Event April 2008 Published
Volume:	Volume 23
Number:	Number 4
Number of Pages:	7
Page Range:	pp. 1278-1284
DOI:	10.1093/ndt/gfm798
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access
Funder:	Sanofi Aventis (Firm)

Data sourced from Thomson Reuters' Web of Knowledge

Request changes or add full text files to a record

Repository staff actions (login required)

View Item