PROMOTING ACCESS TO AFRICAN RESEARCH

Ghana Medical Journal

Log in or Register to get access to full text downloads.

Remember me or Register



Microalbuminuria, Other Markers of Nephropathy and Biochemical Derangements in Type 2 Diabetes Mellitus: Relationships and Determinants

Ademola A. Idowu, Abiodun O. Ajose, Adeoye T. Adedeji, Adegbola O. Adegoke, Kayode A. Jimoh

Abstract


Background: Microalbuminuria is an early indicator of Diabetic nephropathy and cerebrovascular disease.

Objective: To evaluate relationships between microalbuminuria and other predictors of morbidity and mortality in type 2 DM.

Methods: Fifty type 2 diabetic subjects were recruited each for three groups separated by disease durations. Thirty non-diabetic subjects were recruited to control each group. Urine albumin-to-creatinine ratio (ACR) was estimated. Fasting plasma glucose (FPG), serum creatinine, urea, total cholesterol (TC), triglycerides (TG), high- and low density lipoprotein (HDL, LDL) were measured.

Results: The diabetics with longest disease duration of >10 years were the oldest (65.86±1.71), had highest systolic BP (147.12±3.39mmHg) and least BMI (27.20±0.71Kg/m2); they had poorest lipid control (TC:5.54±0.26mmol/L),
though with the least TG (0.97±0.09mmol/L); they also had the most severe microalbuminuria (33.63±8.03g/L) and ACR (65.85±10.38mg/gm). Patients with diabetes of 5-10 years had the poorest glycaemic control:FPG- 7.82±0.47mmol/L; HbA1c-13.09±0.74%). Significant negative correlations exist between microalbuminuria,
HBA1c(r=-2.28, p=0.028) and serum creatinine(r=-2.11,p=0.042) in patients with 5-10 years disease; a positive correlation between the ACR and TC(r=1.00,p<0.01) in those with >10 years disease. In multivariate analysis, independent predictors of microalbuminuria were disease duration (OR 2.2, p< 0.001); HBA1c (OR 7.3, p=0.02); LDL/HDL ratio (OR 13.4, p< 0.001).

Conclusion: The severity and progression of albuminuria are associated with longer duration of diabetes and poor glycaemic control. Significant relationships exist between ACR and HBA1c, TC, HDL-C, TG, creatinine. Disease duration, ethnicity, HBA1c, TC, TG, HDL-C and LDL/HDL ratio are independent predictors of albuminuria.

Keywords: diabetes, microalbuminuria, albumin-to-creatinine ratio, dyslipidaemia, nephropathy, cardiovascular disease

Funding: None declared




AJOL African Journals Online