Microalbuminuria in a random cohort of recently diagnosed type 2 (non-insulin-dependent) diabetic patients living in the Greater Munich Area

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Abstract
Still under debate is the prevalence of microalbuminuria in patients with recently diagnosed Type 2 (non-insulin-dependent) diabetes mellitus and its relation to existing macro-vascular disease and the major vascular risk markers. Hence, from a representative sample of 1512 patients with Type 2 diabetes of varied duration (recruited from 22 nonspecialized medical practices of the Greater Munich Area) 68 (26 males, 42 females) of 71 eligible subjects with a known duration of diabetes of up to 17 weeks and not less than 4 weeks were examined in the present study. Median age was 61 (39 to 75) years, prevalence of ischaemic heart disease (case history plus ECG, Minnesota code, Whitehall criteria) 41.2%, and that of peripheral vascular and carotid artery disease (both assessed by ultrasound-Doppler) were 35.3 and 4.4%, respectively. Diabetes was well controlled (HbA1c: 6.9%, 5.6–8.3; fasting blood glucose: 7.7 mmol/l, 5.4–10.4; median±interquartile range IQ), the cardiovascular risk profile was most prominent in terms of triglycerides (3.1 mmol/l, 2.1–4.6, median±IQ range) and systolic blood pressure (164 mm Hg, 140–186, median±IQ range). 13.2% showed signs of urinary tract infection. Of the remainder, 19.0% exhibited microalbuminuria (RIA, >30–200 mg/l), and 5.2% macroalbuminuria (>200 mg/l). Significant correlations (p2-microglobubin in serum, systolic blood pressure, serum triglycerides, serum HDL-cholesterol (inversely), HbA1c, and peripheral vascular disease. The results suggest a high prevalence of increased urinary albumin excretion in recently diagnosed Type 2 diabetic patients and a close relationship with several hallmarks of the so-called metabolic syndrome, probably operative in the pre-clinical state of Type 2 diabetes. Based on these observations, increased albuminuria could be a marker of early and accelerated atherosclerosis.