Racial and Ethnic Differences in Microalbuminuria Prevalence in a Diabetes Population

Young, Bessie A.; Katon, Wayne; Korff, Michael Von; Simon, Greg; Lin, Elizabeth; Ciechanowski, Paul; Bush, Terry; Oliver, Malia; Ludman, Evette

doi:10.1681/asn.2004030162

Cited by 87 publications

(63 citation statements)

References 70 publications

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“…This would decrease the chances of potential errors related to misclassification of complications associated with DM. The prevalence of micro-and macroalbuminuria, elevated serum creatinine levels and ESRD has been reported to be increased in black patients compared to whites (10,12,(17)(18)(19)(27)(28)(29)(30). In the present study, the rate of ESRD was significantly higher in black patients, even after controlling for other possible risk factors, confirming previously reported data.…”

Section: Odds Ratio (95%ci)supporting

confidence: 90%

Vascular complications of black patients with type 2 diabetes mellitus in Southern Brazil

Gerchman¹,

Zanatta²,

Burttet³

et al. 2008

Braz J Med Biol Res

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Ethnicity has been shown to be associated with micro-and macrovascular complications of diabetes in European and North American populations. We analyzed the contribution of ethnicity to the prevalence of micro-and macrovascular complications in Brazilian subjects with type 2 diabetes attending the national public health system. Data from 1810 subjects with type 2 diabetes (1512 whites and 298 blacks) were analyzed cross-sectionally. The rates of ischemic heart disease, peripheral vascular disease, stroke, distal sensory neuropathy, and diabetic retinopathy were assessed according to self-reported ethnicity using multiple logistic regression models. Compared to whites, black subjects [odds ratio = 1.72 (95%CI = 1.14-2.6)] were more likely to have ischemic heart disease when data were adjusted for age, sex, fasting plasma glucose, HDL cholesterol, hypertension, smoking habit, and serum creatinine. Blacks were also more likely to have end-stage renal disease [3.2 (1.7-6.0)] and proliferative diabetic retinopathy [1.9 (1.1-3.2)] compared to whites when data were adjusted for age, sex, fasting plasma glucose, HDL cholesterol, hypertension, and smoking habit. The rates of peripheral vascular disease, stroke and distal sensory neuropathy did not differ between groups. The higher rates of ischemic heart disease, end-stage renal disease and proliferative diabetic retinopathy in black rather than in white Brazilians were not explained by differences in conventional risk factors. Identifying which aspects of ethnicity confer a higher risk for these complications in black patients is crucial in order to understand why such differences exist and to develop more effective strategies to reduce the onset and progression of these complications.

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Section: Odds Ratio (95%ci)supporting

confidence: 90%

Vascular complications of black patients with type 2 diabetes mellitus in Southern Brazil

Gerchman¹,

Zanatta²,

Burttet³

et al. 2008

Braz J Med Biol Res

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“…A large US primary care study of people with diabetes found that those of Asian origin without hypertension had two-fold prevalence of microalbuminuria (32). These observations seem to be at odds with our findings and are discussed further below.…”

Section: Comparison With Other Studiescontrasting

confidence: 50%

Microalbuminuria and Coronary Heart Disease Risk in an Ethnically Diverse UK Population

Tillin

Forouhi

McKeigue

et al. 2005

Journal of the American Society of Nephrology

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Microalbuminuria (MA) is a strong risk factor for subsequent chronic disease, both renal and coronary heart disease (CHD), in European origin populations, but CHD risks differ by ethnicity, and it was hypothesized that prevalence of MA and relations with CHD may also differ. Combined analyses of two population-based cohorts started in 1988 and consisted of 1460 Europeans (70% male), 946 South Asians (78% male), and 559 African Caribbeans (51% male) who resided in London and were aged 40 to 69. Baseline fasting blood, overnight urine collection, and clinical measurements were performed. Prevalent CHD was defined by clinical history or major electrocardiogram changes. Age-adjusted albumin excretion rates (AER; geometric means, g/min) were significantly higher in African Caribbeans (men: 6.1, 95% confidence interval [CI] 5.5 to 6.7; women: 5.7, 95% CI 5.2 to 6.2) than in South Asians (men: 4.3, 95% CI 4.0 to 4.5; women 3.4, 95% CI 3.0 to 3.8) and Europeans (men: 4.5, 95% CI 4.3 to 4.8; women: 3.3, 95% CI 3.1 to 3.6). MA was associated with both prevalent CHD and CHD mortality in South Asian men (hazard ratio 2.5; 95% CI 1.3 to 4.8) and in European women (hazard ratio 13.0; 95% CI 2.6 to 64.2) but not in any other group. Greater AER in African Caribbeans and the absence of association with CHD contrast with lower AER in South Asian men and European women, both strongly associated with CHD prevalence and mortality. These differences suggest that the pathogenesis of kidney disease and its link with CHD differ by ethnicity and gender.

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“…Development of MA is associated with glycaemic control, blood pressure, smoking, and male gender (3,4). MA may precede type 2 diabetes, occurring in parallel with the metabolic syndrome and its components, obesity and hypertension (1).…”

Section: Introductionmentioning

confidence: 99%

An insulin-like growth factor-I gene polymorphism modifies the risk of microalbuminuria in subjects with an abnormal glucose tolerance

Rietveld

Hofman²,

Pols³

et al. 2006

eur j endocrinol

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Objective: Microalbuminuria (MA) is related to cardiovascular disease both in diabetic patients and non-diabetic subjects. Design: We investigated whether a polymorphism near the promoter region of the IGF-I gene was related to the development of MA. Methods: For this study, 1069 participants of the Rotterdam study were selected (440 participants with an abnormal glucose tolerance (AGT), 220 participants with type 2 diabetes and 254 subjects with pre-diabetes, and 595 subjects with a normal glucose tolerance (NGT). Results: 787 subjects were carriers of the wild type IGF-I genotype (73.6%) and 282 subjects were variant carriers (26.4%) of this IGF-I gene polymorphism. Compared to subjects with NGT the risk for microalbuminuria was higher (Odds Ratio (OR): 3.1 (95% CI: 1.2-7.7); P ¼ 0.02) in variant carriers with AGT than in carriers of the wild type of this IGF-I gene polymorphism (OR: 2.2 (95% CI: 1.2 -4.0); P ¼ 0.009). Compared with wild type carriers with AGT, the relative risk for MA was unadjusted and non-significantly increased in variant carriers with AGT (1.6; 95% CI: 0.8 -2.9). However, after adjustment for possible confounding factors (age, gender, mean blood pressure, fasting insulin, fasting glucose and smoking) this risk became significant (OR: RR 2.1; 95% CI:1.1 -4.4; P ¼ 0.04). Conclusions: In subjects with AGT, a higher risk for MA was observed in variant carriers than in carriers of the wild type genotype of this IGF-I gene polymorphism. Since MA is primarily associated with cardiovascular disease in subjects with AGT, our study suggests that variant carriers have a higher risk for cardiovascular disease than carriers of the wild type when they develop an AGT. European Journal of Endocrinology 154 715-721

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Racial and Ethnic Differences in Microalbuminuria Prevalence in a Diabetes Population

Cited by 87 publications

References 70 publications

Vascular complications of black patients with type 2 diabetes mellitus in Southern Brazil

Vascular complications of black patients with type 2 diabetes mellitus in Southern Brazil

Microalbuminuria and Coronary Heart Disease Risk in an Ethnically Diverse UK Population

An insulin-like growth factor-I gene polymorphism modifies the risk of microalbuminuria in subjects with an abnormal glucose tolerance

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