No abstract

This study was aimed at revealing the factors and the interrelationships between factors on microalbuminuria development among type 2 diabetes (T2D) patients. Between 2004 and 2011, 461 T2D patients with a baseline urine albumin-to-creatinine ratio (UACR) of 530 mg/g, and an estimated glomerular filtration rate (eGFR) of 460 mL/min were evaluated retrospectively. Sixty-eight (14.8%) subjects had developed microalbuminuria in a mean follow-up of 6.82 years. Statistical analysis had revealed that the higher baseline UACR (10 mg/g; sensitivity, 80.9%, specificity, 63.6%; AUC ¼ 0.774) and glycohemoglobin level (HbA1c) (8%; sensitivity, 72.1%, specificity, 61.6%; AUC ¼ 0.698) were the two independent microalbuminuria risk factors. When considering the risk of microalbuminuria, the data were normalized with respect to subjects with low-normal UACR (510 mg/g) and HbA1c58%. The adjusted hazard ratio for subjects with low-normal UACR/HbA1c48%, high-normal UACR/HbA1c58%, and high-normal UACR/HbA1c 48% were 2.59 (p ¼ 0.107), 6.15 (p ¼ 0.001), and 16.96 (p50.001), respectively. It was determined that an increase of HbA1c levels (58, 8-9, 9-10, 410%) showed a progressively increase of the hazard risk in baseline high-normal UACR group. But the same correlation was not shown in the low-normal UACR group. This study identified the relationships of highnormal albuminuria and glycemic control on microalbuminuria development among T2D patients. Glycemic control is especially beneficial for T2D patients with baseline high-normal UACR in preventing microalbuminuria development.