Original InvestigationsRisk factors for microalbuminuria in black americans with newly diagnosed type 2 diabetes
Section snippets
Study population
We studied black patients with type 2 diabetes from an economically disadvantaged urban population with low levels of literacy and poor health insurance coverage.14, 31 Patients with a diabetes diagnosis for 2 years or less who presented to the Grady Diabetes Clinic (Atlanta, GA) for the first time between January 1, 1994, and December 31, 1996, were eligible for inclusion. Patients with both urine albumin and urine creatinine measurements at this visit were included in the analyses; patients
Results
Record review identified 1,167 eligible patients. Adequate information was available to calculate the Alb/Cr ratio for 1,055 of these patients (90.4%). Eleven patients with serum creatinine levels of 2 mg/dL or greater were excluded. Of the remaining 1,044 patients, 40 patients (3.8%) had clinical nephropathy (Alb/Cr >250 μg/mg) at the initial visit, 244 patients (23.4%) had microalbuminuria, and 760 patients (72.8%) had normoalbuminuria (Table 1).
Discussion
The urban black Americans with type 2 diabetes in our study had a high prevalence of microalbuminuria despite short duration (≤2 years) of diagnosed diabetes. Studies of other nonwhite type 2 diabetic populations have also noted a high prevalence of microalbuminuria; however, these studies did not focus solely on those with short diabetes duration.14, 15, 38, 39 Few studies have examined microalbuminuria in black Americans with type 2 diabetes.
Patients with type 2 diabetes are believed to have
References (55)
- et al.
The changing natural history of nephropathy in type I diabetes
Am J Med
(1985) - et al.
Diabetic nephropathy in type II diabetes
Am J Kidney Dis
(1996) - et al.
Renal disease in hypertensive adults: Effect of race and type II diabetes mellitus
Am J Kidney Dis
(1989) Microalbuminuria as a predictor of clinical diabetic nephropathy
Kidney Int
(1987)- et al.
Clinical factors associated with urinary albumin excretion in type II diabetes
Am J Kidney Dis
(1995) - et al.
Albuminuria and associated medical risk factors: A cross-sectional study in 451 type II (non-insulin-dependent) diabetic patients
J Diabetes Complications
(1991) - et al.
Clinical characteristics associated with microalbuminuria in an adult diabetic population
J Diabetes Complications
(1990) - et al.
Prevalence and causes of albuminuria in non-insulin-dependent diabetic patients
Kidney Int
(1992) - et al.
Diabetes in urban African Americans. III. Management of type II diabetes in a municipal hospital setting
Am J Med
(1996) - et al.
Insulin resistance is related to albuminuria in patients with type II (non-insulin-dependent) diabetes mellitus
Metabolism
(1993)
Epidemiology of persistent proteinuria in type II diabetes mellitus
Diabetes
Diabetic nephropathy in type I (insulin-dependent) diabetes: An epidemiological study
Diabetologia
The natural history of insulin-dependent diabetes mellitus in Denmark. 1. Long-term survival with and without late diabetic complications
Diabetes Med
Epidemiologic approach to the etiology of type I diabetes mellitus and its complications
N Engl J Med
Diabetes in African Americans, in Diabetes in America
End-stage renal disease in African-American and white men: 16-Year MRFIT findings
JAMA
The excess incidence of diabetic end-stage renal disease among blacks
JAMA
Microalbuminuria predicts clinical proteinuria and early mortality in maturity-onset diabetes
N Engl J Med
Albuminuria and poor glycemic control predict mortality in NIDDM
Diabetes
Diabetes in urban African-Americans. II. High prevalence of microalbuminuria and nephropathy in African-Americans with diabetes
Diabetes Care
Incipient and overt diabetic nephropathy in African-Americans with NIDDM
Diabetes Care
Microalbuminuria in a random cohort of recently diagnosed type 2 (non-insulin-dependent) diabetic patients living in the greater Munich area
Diabetologia
Epidemiology of renal involvement in newly diagnosed middle-aged and elderly diabetic patients. Cross-sectional data from the population-based study “Diabetes Care in General Practice.”
Diabetologia
Urinary albumin excretion over 3 years in diet-treated type 2 (non-insulin-dependent) diabetic patients, and association with hypertension, hyperglycemia and hypertriglyceridaemia
Diabetologia
Albuminuria in type 2 (non-insulin-dependent) diabetes mellitus and impaired glucose tolerance in Pima Indians
Diabetologia
How frequent is microalbuminuria (MA) in type II diabetes of recent onset and is MA related to genetic factors
J Am Soc Nephrol
Prevalence and risk factors for microalbuminuria in an Italian population-based cohort of NIDDM subjects
Diabetes Care
Cited by (52)
Insulin resistance and diabetic nephropathy
2023, Medecine des Maladies MetaboliquesDiabetes mellitus and macrovascular disease: epidemiology and cardiovascular risk assessment
2023, Cardiovascular Endocrinology and Metabolism: Theory and Practice of Cardiometabolic MedicineObesity and Diabetic Kidney Disease
2013, Medical Clinics of North AmericaMicroalbuminuria and metabolic risk factors in patients with type 2 diabetes in primary care setting in Thailand
2009, Diabetes Research and Clinical PracticeCitation Excerpt :Our study supports the evidence that poor glycemic control as measured by HbA1c was associated with microalbuminuria [22]. The positive association of hypertension, hypertriglyceridemia with microalbuminuria was consistent with several studies [8–10,22–24]. The findings of several risk factors for albuminuria including age, male, duration of diseases, and smoking were also consistent with those studies [8,10,24].
Metabolic Syndrome and the Development of CKD in American Indians: The Strong Heart Study
2008, American Journal of Kidney DiseasesCitation Excerpt :In conclusion, in American Indians, early metabolic changes associated with increased blood pressure and/or insulin resistance appear to adversely influence temporal changes in kidney function measured by means of ACR and eGFR, mediated in part by the development of type 2 diabetes. This agrees with an analysis performed in the Atherosclerosis Risk in Communities cohort13 and other literature that suggest CKD often occurs before or closely after the development of diabetes.31-33 These findings suggest the need for additional research to assess whether screening for early signs of kidney disease in those at high risk of overt diabetes, such as those with metabolic syndrome, may identify persons with undiagnosed CKD.
Received September 20, 1999; accepted in revised form May 26, 2000.
Address reprint requests to William M. McClellan, MD, Georgia Medical Care Foundation, 57 Executive Park South NE, Ste 200, Atlanta, GA 30329-2224. E-mail: [email protected]