High normal albuminuria is associated with arterial stiffness and carotid atherosclerosis in Korean patients with type 2 diabetes

Yoon, Hye Eun; Kim, E.S.; Mo, Eun Young; Shin, Seok Joon; Moon, Sung Dae; Han, Je Ho

doi:10.1016/j.numecd.2015.03.011

Cited by 14 publications

(15 citation statements)

References 33 publications

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“…Several studies have indicated that normal-to-mildly increased albuminuria (<3.39 mg/mmol) is associated with a higher risk of diabetic complications, such as coronary artery disease, heart failure, and atherosclerosis 26 – 28 . It has been reported that normal-to-mildly increased albuminuria may be a risk factor for cardiovascular disease, in patients with and without diabetes 29 .…”

Section: Discussionmentioning

confidence: 99%

Normal-to-mildly increased albuminuria predicts the risk for diabetic retinopathy in patients with type 2 diabetes

Lee

Han

Lee

et al. 2017

Sci Rep

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Albuminuria is closely associated with diabetic retinopathy (DR), but the precise role of the albumin-to-creatinine ratio (ACR) in screening for DR remains to be determined. This study aimed to investigate an ACR threshold for predicting DR in patients with type 2 diabetes. A cross-sectional study was conducted on 1,102 type 2 diabetes patients, aged ≥30 years and recruited from the Korea National Health and Nutrition Examination Survey, 2010–2011. Participants were grouped by stage of DR: mild-to-moderate nonproliferative DR (NPDR), severe NPDR, and proliferative diabetic retinopathy (PDR). An early morning spot urine sample was obtained for ACR measurement. ROC curve analysis revealed that the optimal cut-off value of ACR for predicting DR was 2.26 mg/mmol (20 μg/mg). The prevalence of ACR ≥ 2.26 mg/mmol tended to increase with severity of DR. The risk for DR in patients with ACR ≥ 2.26 mg/mmol was higher than in those with ACR < 2.26 mg/mmol. The risk for severe NPDR and PDR also increased at ACR ≥ 2.26 mg/mmol. Normal-to-mildly increased albuminuria (an ACR of 2.26 mg/mmol) may predict the risk for DR development and progression in patients with type 2 diabetes.

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Section: Discussionmentioning

confidence: 99%

Normal-to-mildly increased albuminuria predicts the risk for diabetic retinopathy in patients with type 2 diabetes

Lee

Han

Lee

et al. 2017

Sci Rep

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“…5 There is also emerging evidence that low-grade albuminuria was significantly associated with subclinical atherosclerosis. [6][7][8] However, studies that investigated the effect of ACR level on the risks of cardiovascular events and all-cause deaths by different status of subclinical atherosclerosis are still limited.…”

Section: Introductionmentioning

confidence: 99%

Urinary albumin-to-creatinine ratio levels are associated with subclinical atherosclerosis and predict CVD events and all-cause deaths: a prospective analysis

Liu

Niu

et al. 2021

BMJ Open

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ObjectiveWe aimed to examine the associations of urinary albumin-to-creatinine ratio (ACR) levels with risks of subclinical atherosclerosis, cardiovascular events and all-cause deaths.MethodsData from a large population-based cohort were used, which included 9580 participants aged ≥40 years free from cardiovascular diseases. Carotid intima–media thickness, brachial-ankle pulse wave velocity and ankle-brachial index were measured at baseline to assess subclinical atherosclerosis. After a median of 4.53 years’ follow-up, 486 cardiovascular events and 230 all-cause deaths were recorded.ResultsThe urinary ACR levels were categorised into three groups. Compared with the normal group (0≤ACR <7.82 mg/g), people with low-grade albuminuria (7.82≤ACR <30 mg/g) and albuminuria (ACR ≥30 mg/g) had higher levels of subclinical atherosclerosis. In prospective analysis, people with low-grade albuminuria was not significantly associated with cardiovascular events (HR=1.18; 95% CI 0.95 to 1.46], whereas people with albuminuria had a 50% higher risk of cardiovascular events (HR=1.50; 95% CI 1.11 to 2.03). People with low-grade albuminuria and albuminuria had 43% (HR=1.43; 95% CI 1.05 to 1.93) and 87% (HR=1.87; 95% CI 1.24 to 2.81) higher risks of all-cause deaths during follow-up, respectively. In stratified analysis, the association of higher ACR with risks of cardiovascular events and all-cause deaths was stronger among individuals with concomitant subclinical atherosclerosis, the presence of diabetes and more cardiovascular risk factors, respectively.ConclusionsACR levels were positively associated with subclinical atherosclerosis and predicted the risks of cardiovascular events and all-cause deaths. Evaluation of ACR levels should be integrated into risk stratification and prevention of cardiovascular events and all-cause deaths, especially among those with pre-existing subclinical atherosclerosis and cardiometabolic abnormalities.

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“…As a predictive marker of renal and cardiac outcomes, the urine albumin-tocreatinine ratio (UACR) has been incorporated into the definition and staging of chronic kidney disease. 1 Reportedly, a high UACR is associated with the risk of left ventricular hypertrophy, 2 arterial stiffness, carotid atherosclerosis, 3 diabetic peripheral arterial disease (PAD), 4 onset of diabetic retinopathy, 5 chronic renal disease and hypertension. 6 Diabetic peripheral neuropathy (DPN) can lead to neuropathic pain, which worsens the quality of life.…”

Section: Introductionmentioning

confidence: 99%

Change in Urine Albumin-to-Creatinine Ratio and Risk of Diabetic Peripheral Neuropathy in Type 2 Diabetes: A Retrospective Cohort Study

Ming¹,

Yang²,

Zhang³

et al. 2021

DMSO

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High normal albuminuria is associated with arterial stiffness and carotid atherosclerosis in Korean patients with type 2 diabetes

Cited by 14 publications

References 33 publications

Normal-to-mildly increased albuminuria predicts the risk for diabetic retinopathy in patients with type 2 diabetes

Normal-to-mildly increased albuminuria predicts the risk for diabetic retinopathy in patients with type 2 diabetes

Urinary albumin-to-creatinine ratio levels are associated with subclinical atherosclerosis and predict CVD events and all-cause deaths: a prospective analysis

Change in Urine Albumin-to-Creatinine Ratio and Risk of Diabetic Peripheral Neuropathy in Type 2 Diabetes: A Retrospective Cohort Study

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