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01-10-2015 | Original Article

Independent correlates of urinary albumin excretion within the normoalbuminuric range in patients with type 2 diabetes: The Renal Insufficiency And Cardiovascular Events (RIACE) Italian Multicentre Study

Authors: Giuseppe Penno, Anna Solini, Giacomo Zoppini, Cecilia Fondelli, Roberto Trevisan, Monica Vedovato, Franco Cavalot, Gabriella Gruden, Olga Lamacchia, Luigi Laviola, Emanuela Orsi, Giuseppe Pugliese, Renal Insufficiency Cardiovascular Events (RIACE) Study Group

Published in: Acta Diabetologica | Issue 5/2015

Abstract

Aims

Within the normoalbuminuric range, low albuminuria (LA, 10–29 mg/24 h) is associated with higher adverse cardiovascular and renal outcomes than normal albuminuria (NA, <10 mg/24 h). This cross-sectional analysis of the cohort from the Renal Insufficiency And Cardiovascular Events (RIACE) Italian Multicentre Study was aimed at assessing the independent correlates of LA versus NA in patients with type 2 diabetes.

Methods

This analysis involved 11,538 normoalbuminuric patients (73.2 % of the entire RIACE cohort): 6023 (52.2 %) with NA and 5515 (47.8 %) with LA. Binary logistic regression analysis with backward conditional variable selection was applied to assess the independent correlates of LA versus NA.

Results

Compared with NA subjects, LA patients were more frequently males, older and with family history of hypertension, had longer diabetes duration, lower HDL cholesterol, and higher haemoglobin (Hb) A_1c, triglycerides, and blood pressure (BP), use of anti-hyperglycaemic and anti-hypertensive drugs, and prevalence of metabolic syndrome, retinopathy, chronic kidney disease, any cardiovascular disease, myocardial infarction, and coronary and peripheral events. Men with LA were also more frequently current or former smokers and had higher body mass index, waist circumference, and non-HDL cholesterol. Independent correlates of LA were age (OR 1.018), family history of hypertension (OR 1.321), smoking status (former, OR 1.158; current, OR 1.237), HbA_1c (OR 1.062), waist circumference (OR 1.050), triglycerides (OR 1.001), and diastolic BP (OR 1.014), together with use of anti-hyperglycaemic and anti-hypertensive agents.

Conclusions

Several risk factors are associated with increased albuminuria within the normoalbuminuric range. As most of these factors are potentially modifiable, treating them aggressively might reduce the excess risk associated with LA.

Trial registration

NCT00715481; www.ClinicalTrials.gov.

Available only for authorised users

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Title: Independent correlates of urinary albumin excretion within the normoalbuminuric range in patients with type 2 diabetes: The Renal Insufficiency And Cardiovascular Events (RIACE) Italian Multicentre Study
Authors: Giuseppe Penno
Anna Solini
Giacomo Zoppini
Cecilia Fondelli
Roberto Trevisan
Monica Vedovato
Franco Cavalot
Gabriella Gruden
Olga Lamacchia
Luigi Laviola
Emanuela Orsi
Giuseppe Pugliese
Renal Insufficiency Cardiovascular Events (RIACE) Study Group
Publication date: 01-10-2015
Publisher: Springer Milan
Published in: Acta Diabetologica / Issue 5/2015
Print ISSN: 0940-5429
Electronic ISSN: 1432-5233
DOI: https://doi.org/10.1007/s00592-015-0789-x

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