Study of incidence of microalbuminuria among first diagnosed diabetic patients and its correlation with body mass index and coexisting hypertension in a tertiary care hospital

  • Esakki Muthuvel Saveetha Medical College and Hospital, Thandalam, Chennai - 602105
  • Vimal Chander Saveetha Medical College and Hospital, Thandalam, Chennai - 602105.
  • Sowmiya Balu Tagore Medical College and Hospital, Rathinamangalam, Candour Post, Chennai – 48.
Keywords: Microalbuminuria, diabetes mellitus, body mass index, hypertension, type 2 diabetes

Abstract

Background: Diabetes is raising recently more in the developing countries due to sedentary life style and with increase in duration, complications arise affecting renal, retinal, cardiovascular and nervous systems. Diabetic nephropathy poses a great risk of renal failure and is the cause for performing dialysis. Microalbuminuria is the earliest marker for the renal and cardiovascular involvement. This study aims to study the incidence of microalbuminuria in first diagnosed diabetic patients and to correlate it with the body mass index (BMI), hypertension and waist hip circumference.Methods: This study was conducted on 138 first diagnosed diabetic patients in a tertiary care hospital. Microalbuminuria was analyzed using dipstick method and correlation was made with parameters such as blood pressure, body mass index, and waist-hip circumference.Result: The incidence of microalbuminuria in first diagnosed diabetic patients was 17%. Incidence of microalbuminuria is increased in hypertensive diabetic patients (37%) compared with non-hypertensive diabetic patients (10%) which was statistically significant (p=0.001, r=0.292). Incidence of microalbuminuria among first diagnosed diabetic patients was 17%. The correlation of microalbuminuria with hypertension, BMI and waist-hip ratio suggest that microalbuminuria incidence is significantly associated with hypertension than BMI and waist-hip ratio.Conclusion: Microalbuminuria is the earliest indicator for detecting nephropathy. The incidence of microalbuminuria of 17% during first diagnosis of diabetes indicates the inadequacy in the health care system regarding the screening programs in the rural population. Thus, improvements must be made in the health care system to reduce the incidence rate by effective screening program. DOI: 10.21276/APALM.1259

References

1. Varghese A, Deepa R, Rema M, Mohan V. Prevalence of microalbuminuria in type 2 diabetes mellitus at a diabetes centre in southern India. Postgrad Med J 2001;77:399-402.
2. Mogensen CE. Preventing end-stage renal disease. Diabet Med 1998;15 Suppl 4:S51-6.
3. Kong NC, Chia YC, Khalid BA, et al. Microalbuminuria prevalence study in hypertensive type 2 diabetic patients in Malaysia. Med J Malaysia 2006 Oct;61(4):457-65.
4. Lehmann R, Spinas GA. Diabetic nephropathy: significance of microalbuminuria and proteinuria in Type I and Type II diabetes mellitus. Praxis. 1995;84(44):1265-71.
5. Valensi P, Ferrière F, Attali JR, Erault C, Modigliani E, Delrieux C, Sebaoun J. Microalbuminuria in diabetics with moderate hypertension. Arch Mal Ceur Vaiss. 1986;79(6):785-9.
6. Zarini GG, Exebio JC, Gundupalli D, Nath S, Huffman FG. Hypertension, poor glycemic control, and microalbuminuria in Cuban Americans with type 2 diabetes. Int J Nephrol Renovasc Dis 2011;4:35-40.
7. Vasović O, Zamaklar M, Lalić K, Milosević D, Zikić L, Popović L. The prevalence of hypertension and microalbuminuria in diabetes mellitus type 1 and type 2. Srp Arh Celok Lek. 2005;133(5-6):229-32.
8. Descamps O, Buysschert M, Ketelslegers JM, Hermans M, Lambert E. Microalbuminuria in a population of 653 patients with type 1 and 2 diabetes. Diabete Metab 1991;17(5):469-75.
9. Ohashi H, Oda H, Ohno M, Watanabe S. Weight reduction improves high blood pressure and microalbuminuria in hypertensive patients with obesity. Nihon Jinzo Gakkai shi 2001; 43(4):333-339.
10. Thoenes M, Reil JC, Khan BV, et al. Abdominal obesity is associated with microalbuminuria and an elevated cardiovascular risk profile in patients with hypertension. Vasc Health Risk Manag. 2009;5(4):577-85.
11. Nagrebetsky A, Jin J, Stevens R, et al. Diagnostic accuracy of urine dipstick testing in screening for microalbuminuria in type 2 diabetes: a cohort study in primary care. Fam Pract. 2013 Apr;30(2):142-52.
12. Mur Martí T, Franch Nadal J, Morató Griera J, Llobera Serentill A, Vilarrubias Calaf M, Ros Espin C. Nephropathy and microalbuminuria in type II diabetes. Aten Primaria. 1995;16(9):516-24.
13. Weir MR. Albuminuria predicting outcome in diabetes: incidence of microalbuminuria in Asia-Pacific Rim. Kidney Int Suppl. 2004 Nov;(92):S38-9.
14. Gupta DK, Verma LK, Khosla PK, Dash SC. The prevalence of microalbuminuria in diabetes: a study from north India. Diabetes Res Clin Pract 1991 May;12(2):125-8.
15. Lutale JJ, Thordarson H, Abbas ZG, vetvik K. Microalbuminuria among Type 1 and Type 2 diabetic patients of African origin in Dar Es Salaam, Tanzania. Vetvi BMC Nephrol 2007;8:2.
16. Hoffmann IS, Jimenez E, Cubeddu LX. Urinary albumin excretion in lean, overweight and obese glucose tolerant individuals: its relationship with dyslipidaemia, hyperinsulinaemia and blood pressure. J Hum Hypertens 2001 Jun;15(6):407-12.
17. Rossi MC, Nicolucci A, Pellegrini F, et al. Identifying patients with type 2 diabetes at high risk of microalbuminuria: results of the DEMAND (Developing Education on Microalbuminuria for Awareness of reNal and cardiovascular risk in Diabetes) Study. Nephrol Dial Transplant. 2008;23(4):1278-84.
18. Viswanathan M, Snehalatha C, Bhattacharyya PK, Mohan V, Ramachandran A. Microalbuminuria in NIDDM patients in south India. Indian J Med Res 1991;94:125-9.
19. Lum G. How effective are screening tests for microalbuminuria in random urine specimens? Ann Clin Lab Sci 2000;30(4):406-11.
Published
2017-04-19
Issue
Vol 4 No 2 (2017)
Section
Original Article

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