Determinants of urinary albumin excretion within the normal range in patients with type 2 diabetes: the Randomised Olmesartan and Diabetes Microalbuminuria Prevention (ROADMAP) study

Autor: Jr Jl Izzo, Sadayoshi Ito, A J Rabelink, Jan Menne, Shigehiro Katayama, Lars Christian Rump, Hermann Haller, Luis M. Ruilope, Gc Viberti, Eberhard Ritz, Albert Mimran, Andrzej Januszewicz
Rok vydání: 2009
Předmět:
Adult
medicine.medical_specialty
Adolescent
Epidemiology
Endocrinology
Diabetes and Metabolism
Urology
Tetrazoles
Blood Pressure
Diabetic nephropathy
Type 2 diabetes
Article
Placebos
Young Adult
Double-Blind Method
Reference Values
Diabetes mellitus
Internal medicine
Internal Medicine
medicine
Albuminuria
Humans
Hypoglycemic Agents
Albuminuria Diabetes Diabetic nephropathy Epidemiology Hypertension Proteinuria ambulatory blood-pressure chronic kidney-disease cardiovascular risk metabolic syndrome follow-up nondiabetic subjects waist circumference insulin-resistance natural-history pulse pressure
Aged
Glycated Hemoglobin
Proteinuria
business.industry
Patient Selection
Diabetes
Imidazoles
Middle Aged
medicine.disease
Endocrinology
Diabetes Mellitus
Type 2
Creatinine
Hypertension
Electrocardiography
Ambulatory
Microalbuminuria
medicine.symptom
Olmesartan
business
Angiotensin II Type 1 Receptor Blockers
Glomerular Filtration Rate
medicine.drug
Kidney disease
Zdroj: Diabetologia
Diabetologia, 53(1), 49-57
ISSN: 1432-0428
0012-186X
0018-5159
DOI: 10.1007/s00125-009-1577-3
Popis: In contrast to microalbuminuric type 2 diabetic patients, the factors correlated with urinary albumin excretion are less well known in normoalbuminuric patients. This may be important because even within the normoalbuminuric range, higher rates of albuminuria are known to be associated with higher renal and cardiovascular risk. At the time of screening for the Randomised Olmesartan and Diabetes Microalbuminuria Prevention (ROADMAP) Study, the urinary albumin/creatinine ratio (UACR) was 0.44 mg/mmol in 4,449 type 2 diabetic patients. The independent correlates of UACR were analysed. Independent correlates of UACR during baseline were (in descending order): night-time systolic BP (r (s) = 0.19); HbA(1c) (r (s) = 0.18); mean 24 h systolic BP (r (s) = 0.16); fasting blood glucose (r (s) = 0.16); night-time diastolic BP (r (s) = 0.12); office systolic BP, sitting (r (s) = 0.11), standing (r (s) = 0.10); estimated GFR (r (s) = 0.10); heart rate, sitting (r (s) = 0.10); haemoglobin (r (s) = -0.10); triacylglycerol (r (s) = 0.09); and uric acid (r (s) = -0.08; all p a parts per thousand currency signaEuro parts per thousand 0.001). Significantly higher albumin excretion rates were found for the following categorical variables: higher waist circumference (more marked in men); presence of the metabolic syndrome; smoking (difference more marked in males); female sex; antihypertensive treatment; use of amlodipine; insulin treatment; family history of diabetes; and family history of cardiovascular disease (more marked in women). Although observational correlations do not prove causality, in normoalbuminuric type 2 diabetic patients the albumin excretion rate is correlated with many factors that are potentially susceptible to intervention. ClinicalTrials.gov ID no.: NCT00185159 This study was sponsored by Daichii-Sankyo.
Databáze: OpenAIRE
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