caa a22 4500 469128445 CHVBK 20180323133157.0 cr unu---uuuuu 170328e19920901xx s 000 0 eng 10.1007/BF00573499 doi (NATIONALLICENCE)springer-10.1007/BF00573499 Increased urinary albumin excretion aggregates with atherosclerotic risk factors in type 2 (non-insulin-dependent) diabetes mellitus [Elektronische Daten] [G. Penno, O. Giampietro, M. Nannipieri, L. Rizzo, A. Rapuano, R. Miccoli, A. Bertolotto, M. Cecere, A. Lucchetti, R. Navalesi] Supranormal urinary albumin excretion (microalbuminuria) is an early indicator of microangiopathy, i.e. diabetic nephropathy, and is associated with higher cardiovascular mortality in both type 1 and type 2 diabetes. The relationship between the presence of microalbuminuria and some atherosclerotic risk factors has been evaluated in 318 (170 male, 148 female) type 2 (non-insulin-dependent) diabetic subjects [age 63±10 years; known duration of diabetes 10.9±8.8 years; age at diabetes diagnosis 52±11 years; systolic blood pressure (BP) 150±23 mmHg; diastolic BP 86±11 mmHg (mean±SD)]. In "early morning” urine samples, albumin (immunonephelometry) and creatinine were assayed. On the basis of the albumin/creatinine ratio (A/C, mg/mmol), patients were categorized as normoalbuminuric (Na; A/C<2.0;n=159, 50%), microalbuminuric (ma; A/C 2-20;n=135, 42.5%) or macroalbuminuric (Ma; A/C >20;n=24, 7.5%). The three groups were closely matched for age, age at diagnosis, duration of diabetes, and fasting plasma and urinary glucose levels. Systolic and diastolic BP rose progressively with increasing urinary A/C ratio levels. While high-density lipoprotein (HDL) cholesterol was unaffected by albuminuria, total cholesterol (218±45 vs 198±43 mg/dl,P<0.001) and low-density lipoprotein (LDL) cholesterol (145±42 vs 131±38 mg/dl,P<0.05) levels were higher in microalbuminuric than in normoalbuminuric patients. Further, a significant correlation (r=0.16,P<0.01) existed between albuminuria and triglyceride concentrations. Prevalence of arterial hypertension, defined as BP≥160/95 mmHg and/or drug treatment (Na, 51%; ma, 65%; Ma, 78%;P<0.001) and obesity, defined as body mass index (BMI)>30 (Na, 15%; ma, 26%; Ma, 32%;P<0.05) rose with increasing A/C ratios. Both coronary heart disease (30% vs 15%) and intermittent claudication (18% vs 7%) were more frequent in microalbuminuric than in normoalbuminuric subjects. Finally, multiple stepwise regression analysis showed that urinary albumin excretion is significantly and independently associated with coronary heart disease and intermittent claudication, also taking into account hypertension and other established cardiovascular risk factors. In type 2 diabetes microalbuminuria tends to aggregate with risk factors for atherosclerotic vascular disease, e.g. increased prevalence of hypertension and obesity, elevated total and LDL cholesterol, and raised triglycerides levels. These abnormalities may only explain the excess of cardiovascular morbidity and mortality in part. Microalbuminuria per se may be an important and independent cardiovascular risk factor. Springer-Verlag, 1992 Diabetic nephropathy nationallicence Non-insulin-dependent diabetes mellitus nationallicence Microalbuminuria nationallicence Atherosclerosis nationallicence Penno G. Cattedra di Malattie del Metabolismo, Istituto di Clinica Medica II, University of Pisa, Via Roma 67, I-56100, Pisa, Italy aut Giampietro O. Cattedra di Malattie del Metabolismo, Istituto di Clinica Medica II, University of Pisa, Via Roma 67, I-56100, Pisa, Italy aut Nannipieri M. Cattedra di Malattie del Metabolismo, Istituto di Clinica Medica II, University of Pisa, Via Roma 67, I-56100, Pisa, Italy aut Rizzo L. Cattedra di Malattie del Metabolismo, Istituto di Clinica Medica II, University of Pisa, Via Roma 67, I-56100, Pisa, Italy aut Rapuano A. Cattedra di Malattie del Metabolismo, Istituto di Clinica Medica II, University of Pisa, Via Roma 67, I-56100, Pisa, Italy aut Miccoli R. Cattedra di Malattie del Metabolismo, Istituto di Clinica Medica II, University of Pisa, Via Roma 67, I-56100, Pisa, Italy aut Bertolotto A. Cattedra di Malattie del Metabolismo, Istituto di Clinica Medica II, University of Pisa, Via Roma 67, I-56100, Pisa, Italy aut Cecere M. Cattedra di Malattie del Metabolismo, Istituto di Clinica Medica II, University of Pisa, Via Roma 67, I-56100, Pisa, Italy aut Lucchetti A. Cattedra di Malattie del Metabolismo, Istituto di Clinica Medica II, University of Pisa, Via Roma 67, I-56100, Pisa, Italy aut Navalesi R. Cattedra di Malattie del Metabolismo, Istituto di Clinica Medica II, University of Pisa, Via Roma 67, I-56100, Pisa, Italy aut Acta Diabetologica Springer-Verlag 29/3-4(1992-09-01), 250-257 0940-5429 29:3-4<250 1992 29 592 https://doi.org/10.1007/BF00573499 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/BF00573499 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Penno G. Cattedra di Malattie del Metabolismo, Istituto di Clinica Medica II, University of Pisa, Via Roma 67, I-56100, Pisa, Italy aut NATIONALLICENCE 700 1- Giampietro O. Cattedra di Malattie del Metabolismo, Istituto di Clinica Medica II, University of Pisa, Via Roma 67, I-56100, Pisa, Italy aut NATIONALLICENCE 700 1- Nannipieri M. Cattedra di Malattie del Metabolismo, Istituto di Clinica Medica II, University of Pisa, Via Roma 67, I-56100, Pisa, Italy aut NATIONALLICENCE 700 1- Rizzo L. Cattedra di Malattie del Metabolismo, Istituto di Clinica Medica II, University of Pisa, Via Roma 67, I-56100, Pisa, Italy aut NATIONALLICENCE 700 1- Rapuano A. Cattedra di Malattie del Metabolismo, Istituto di Clinica Medica II, University of Pisa, Via Roma 67, I-56100, Pisa, Italy aut NATIONALLICENCE 700 1- Miccoli R. Cattedra di Malattie del Metabolismo, Istituto di Clinica Medica II, University of Pisa, Via Roma 67, I-56100, Pisa, Italy aut NATIONALLICENCE 700 1- Bertolotto A. Cattedra di Malattie del Metabolismo, Istituto di Clinica Medica II, University of Pisa, Via Roma 67, I-56100, Pisa, Italy aut NATIONALLICENCE 700 1- Cecere M. Cattedra di Malattie del Metabolismo, Istituto di Clinica Medica II, University of Pisa, Via Roma 67, I-56100, Pisa, Italy aut NATIONALLICENCE 700 1- Lucchetti A. Cattedra di Malattie del Metabolismo, Istituto di Clinica Medica II, University of Pisa, Via Roma 67, I-56100, Pisa, Italy aut NATIONALLICENCE 700 1- Navalesi R. Cattedra di Malattie del Metabolismo, Istituto di Clinica Medica II, University of Pisa, Via Roma 67, I-56100, Pisa, Italy aut NATIONALLICENCE 773 0- Acta Diabetologica Springer-Verlag 29/3-4(1992-09-01), 250-257 0940-5429 29:3-4<250 1992 29 592 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer