INCIDENCE OF MICROALBUMINURIA AND ASSOCIATED RISK FACTORS IN TYPE 2 DIABETES MELLITUS

Microalbuminuria represents the earliest clinical of renal involvement and reflects the progression of diabetic nephropathy and increased risk of mortality in diabetic patients. The incidence of diabetic nephropathy in type 2 diabetes differs widely by race. The aim of this study was to determine the incidence of and risk factors for microalbuminuria in type 2 diabetic patients. As a cohort study 505 (22%male, mean age: 57.4±9.5 years and diabetes duration 10.2±4.7 years at initial registration) type 2 diabetic patients with initial normoalbuminuria were followed prospectively for 5 years in isfahan endocrine and metabolism research center. Patients were evaluated for BMI, HbA1c, blood pressure, lipid profile, serum creatinine and 24 hours urine albumin. Normoalbuminuria were defined as urine albumin excretion less than or equal to 30 mg/24 h and microalbuminuria as 31-299 mg/24 h. Logistic regression model were used to assess the associations. 176 revealed persistently elevated UAE during follow-up, giving an incidence of 82.3/1000 person-years(95%CI:78/3-86/2). Incidence of microalbuminuria were significantly higher in men than wemen(104.4 and 66.2/1000 person-year, P<0.001).The mean values of HbA1c, duration of diabetes, systolic hypertension and serum creatinin during the follow-up period were significantly higher in the microalbuminuric than in the normoalbuminuric patients. Age, BMI, cholesterol and triglyceride were not significantly different in two groups. Logistic regression analysis revealed that duration of diabetes, HbA1c, high blood pressure and retinopathy during follow-up are independent variables that have a statistically significant influence on the development of microalbuminuria. These result revealed that microalbuminura in this population of type 2 diabetic patients were common and higher than of other studies. These findings suggest that urine excretion of albumin should be monitored routinely in this patients for detection early stages of nephropathy and effective treatment of microalbuminura and associated risk factors are very important.