Urine Albumin-to-Creatinine Ratio: A Marker of Early Endothelial Dysfunction in Youth

Bartz, Sara Klinepeter; Caldas, Maria Clara S; Tomsa, Anca; Krishnamurthy, Ramkumar; Bacha, Fida

doi:10.1210/jc.2015-2230

Cited by 48 publications

(41 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Another recent support argues that HbA1c is associated with low-grade albuminuria in Chinese adults, and it has been suggested that insulin resistance could result in endothelial dysfunction and the dysfunction of the glomerular capillary wall leading to albuminuria [10]. Bartz et al also demonstrated that the adiposity-related insulin resistance to endothelial function may impact renal dysfunction, and so UACR provides an early marker of endothelial dysfunction in obese adolescents [31]. Additionally, this study sought to perform the assessment of endothelial function by peripheral arterial tonometry, and suggests that endothelial dysfunction mediates the link between obesity-related insulin resistance and early microalbuminuria [31].…”

Section: Discussionmentioning

confidence: 99%

“…Bartz et al also demonstrated that the adiposity-related insulin resistance to endothelial function may impact renal dysfunction, and so UACR provides an early marker of endothelial dysfunction in obese adolescents [31]. Additionally, this study sought to perform the assessment of endothelial function by peripheral arterial tonometry, and suggests that endothelial dysfunction mediates the link between obesity-related insulin resistance and early microalbuminuria [31]. The present study also suggests that insulin resistance may play an important role in the development of renal impairment in conjunction with central obesity, which was a crucial component of diagnosis of metabolic syndrome among children and adolescents.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Prevalence of microalbuminuria and its associated cardiometabolic risk factors in Korean youth: Data from the Korea National Health and Nutrition Examination Survey

Cho

Kim

2017

PLoS ONE

View full text Add to dashboard Cite

BackgroundMicroalbuminuria is a known early predictive factor for renal and cardiovascular diseases, not only for patients with diabetes mellitus or hypertension but also in the general population. However, the prevalence and risk factors associated with microalbuminuria in Korean youth are unknown.ObjectivesThe aims of this study are to evaluate the prevalence of microalbuminuria and the association between microalbuminuria and obesity or cardiometabolic risk factors in Korean children and adolescents without diabetes.MethodsThis study examines data obtained from the Korea National Health and Nutrition Examination Survey (between 2011 and 2014). It includes a total of 1,976 participants aged between 10 and 19 years (boys 1,128 and girls 848). Microalbuminuria was defined as a urine albumin-to-creatinine ratio (UACR) of ≥ 30 mg/g and < 300 mg/g. Association between microalbuminuria and the risk factors for cardiometabolic diseases including insulin resistance was evaluated.ResultsThe prevalence of microalbuminuria was found to be 3.0% in Korean children and adolescents over this time period. The mean UACR for non-obese youth was significantly greater than that found in obese youth (3.2 ± 0.1 mg/g in the non-obese group vs. 2.1 ± 0.2 mg/g in the obese group; P < 0.001). In multiple logistic regression analysis, microalbuminuria was associated with hyperglycemia (OR 2.62, 95% CI 1.09–6.30) and hemoglobin A1c (OR 3.34, 95% CI 1.09–10.17) in the non-obese group and hypertension (OR 14.10, 95% CI 1.12–177.98) and HbA1c (OR 6.68, 95% CI 1.87–23.95) in the obese group.ConclusionsThe prevalence of microalbuminuria is not prominent in obese children and adolescents. Our findings demonstrated that the presence of hypertension and hyperglycemia was associated with microalbuminuria. Especially Hemoglobin A1c was associated with microalbuminuria in youths regardless of weight status. Microalbuminuria in pediatric population can be a helpful marker for the risk of cardiovascular disease.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Prevalence of microalbuminuria and its associated cardiometabolic risk factors in Korean youth: Data from the Korea National Health and Nutrition Examination Survey

Cho

Kim

2017

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…Microalbuminuria, defined as albumin-to-creatinine ratio ≥30mg/g or an albumin-excretion-rate ≥200ug/min, has been used as a marker of renal and systemic vascular dysfunction (33) and metabolic risk in adults and adolescents with prediabetes and T2D (34), (35). The implications of having microalbuminuria are, however, controversial, since microalbuminuria regresses to normoalbuminuria in a significant proportion of adults with T2D (36).…”

Section: Risk Factors For Dkd In Youth With T2dmentioning

confidence: 99%

“…Additionally, obesity and impaired glucose tolerance are associated with renal injury that is pathophysiologically and histologically similar to classical diabetic nephropathy (27–29, 51), suggesting that the renal insult may begin prior to the development of frank hyperglycemia (30). For example, a recent report demonstrated increased estimated GFR in adolescents with pre-diabetes and overweight adolescents compared to lean controls (35). …”

Section: Risk Factors For Dkd In Youth With T2dmentioning

confidence: 99%

Diabetic Kidney Disease in Adolescents With Type 2 Diabetes: New Insights and Potential Therapies

et al. 2016

View full text Add to dashboard Cite

Diabetic kidney disease (DKD) is the leading cause of end-stage renal disease (ESRD) and dialysis in the Western world. Early DKD, including microalbuminuria and renal hyperfiltration, are common in adolescents with type 2 diabetes (T2D). Furthermore, youth-onset T2D carries a higher risk of progressive DKD than adult-onset T2D of similar diabetes duration. DKD is characterized by a long clinically-silent period without signs of disease. Therefore, a major challenge in preventing DKD is the difficulty in identifying high-risk T2D patients at an early stage. The Type 2 Diabetes in Adolescents and Youth (TODAY) study demonstrated a high initial prevalence that increased over time, irrespective of treatment arm. This key observation underscores the importance of discovering new therapeutic targets to supplement conventional management, in order to reduce DKD risk. In this review, we focus on early DKD in T2D and summarize potential novel biomarkers and therapeutic targets.

show abstract

“…MAU can play pivotal role in early detection of endothelial changes and CV risk, considering the positive association with FBS, BMI and BP. Precipitating factors of MAU should be managed via lifestyle modifications and medications as it is a reversible condition [14,15]. Thus obese young and middle aged adults should be screened regularly.…”

Section: Discussionmentioning

confidence: 99%

Microalbuminuria in Obese Young and Middle Aged Population: A Potential Marker of Cardiovascular Risk

et al. 2016

View full text Add to dashboard Cite

Microalbuminuria is an established cardiovascular risk indicator in diabetes, hypertension and the general population. There is lack of information on MAU in healthy obese Indian adults and an ongoing debate whether obese adults deserve targeted identification and clinical intervention for MAU and prediabetes. We aimed to screen the healthy obese, young (group I) and middle aged (group II) adults for prevalence of MAU and prediabetes and study its association with Framingham risk score. The study included 50 healthy obese young (20-30 years) and middle aged adults (31-50 years), attending the outpatient clinic of Dept. of Medicine for a duration of 2 months (July-August). The patients were screened for fasting blood sugar, lipid profile and MAU. Of the total patients 28 % had MAU, 32.14 % of which had prediabetes and 33.33 % had diabetes whereas 10 % were normoglycemic. The group I patients had 50 % cases of MAU and group II had 25 % patients with MAU. Group II 63.63 % pre-diabetics. The values of MAU obtained were correlated with age, gender, body mass index, systolic and diastolic blood pressure, FBS, waist to hip ratio using Pearson's Coefficient (p < 0.05). The 10 year CVD risk calculated using FRS in subjects with MAU was higher as compared to those without MAU. Thus we conclude that Indian, young and middle aged obese adults to be at a risk of prediabetes, MAU and CV risk warranting their routine screening for better clinical outcomes.

show abstract

Urine Albumin-to-Creatinine Ratio: A Marker of Early Endothelial Dysfunction in Youth

Abstract: UACR is an early marker of endothelial dysfunction in youth, independent of glycemia. Endothelial dysfunction may mediate the link between obesity-related insulin resistance and early microalbuminuria.

Cited by 48 publications

References 44 publications

Prevalence of microalbuminuria and its associated cardiometabolic risk factors in Korean youth: Data from the Korea National Health and Nutrition Examination Survey

Prevalence of microalbuminuria and its associated cardiometabolic risk factors in Korean youth: Data from the Korea National Health and Nutrition Examination Survey

Diabetic Kidney Disease in Adolescents With Type 2 Diabetes: New Insights and Potential Therapies

Microalbuminuria in Obese Young and Middle Aged Population: A Potential Marker of Cardiovascular Risk

Contact Info

Product

Resources

About