Rossi, M. C. E., Nicolucci, A., Pellegrini, F., Comaschi, M., Ceriello, A., Cucinotta, D., Giorda, C., Pomili, B., Valentini, U., Vespasiani, G. and De Cosmo, S.. (2010) Obesity and changes in urine albumin/creatinine ratio in patients with type 2 diabetes: The DEMAND Study. Nutrition, Metabolism and Cardiovascular Diseases, Vol.20 (No.2). pp. 110-116. ISSN 0939-4753

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Abstract

Background and aims: Obesity is a potential risk factor for renal disease in non-diabetic subjects. It remains unclear whether this also applies to diabetic patients. We investigated whether obesity predicted changes in albumin excretion rate in individuals with type 2 diabetes. Methods and results: Fifty Italian diabetes outpatient clinics enrolled a random sample of 1289 patients. A morning spot urine sample was collected to determine urinary albumin/creatinine ratio (ACR) at baseline and after 1 year from the study initiation. Progression of albumin excretion was defined as a doubling in ACR, while regression was defined as a 50% reduction. Multivariate logistic regression analyses were used to evaluate correlates of these outcomes. Data are expressed as odds ratios (OR) with 95% confidence intervals (Cl). The risk of progression increased by 7% (OR = 1.07; 95%CI 1.00-1.15) for every 5-cm increase in waist circumference measured at baseline, and by 17% (OR = 1.17; 95%CI 1.03-1.33) for every one-unit increase in BMI during follow-up. The likelihood of regression was not independently associated with any of the variables investigated. The effect of obesity on progression of ACR was independent of metabolic control, blood pressure, treatment, and baseline level of albumin excretion. Conclusions: We found a tight link between obesity and changes in albumin excretion in diabetic subjects, suggesting potential benefits of interventions on body weight on end-organ renal damage. (C) 2009 Elsevier B.V. All rights reserved.

Item Type:	Journal Article
Subjects:	Q Science > QM Human anatomy R Medicine > RC Internal medicine R Medicine > RA Public aspects of medicine
Divisions:	Faculty of Medicine > Warwick Medical School
Journal or Publication Title:	Nutrition, Metabolism and Cardiovascular Diseases
Publisher:	Elsevier Ltd
ISSN:	0939-4753
Date:	February 2010
Volume:	Vol.20
Number:	No.2
Number of Pages:	7
Page Range:	pp. 110-116
Identification Number:	10.1016/j.numecd.2009.02.013
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access
Funder:	Sanofi-Aventis
URI:	http://wrap.warwick.ac.uk/id/eprint/5996

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