Albuminuria in Australian Aboriginal people: prevalence and associations with components of the metabolic syndrome

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Abstract
Aims/hypothesis. To examine the prevalence and associations with the metabolic syndrome of albuminuria among Australian Aboriginal people.¶Methods. Early-morning urine specimens were collected as part of community-based risk factor surveys assessing the prevalence of diabetes and cardiovascular disease in eight remote communities, with a sample size of 1,075 people. Microalbuminuria was defined as urinary albumin : creatinine ratio 3.4–33.9 mg/mmol, macroalbuminuria as albumin : creatinine ratio equal to or greater than 34 mg/mmol.¶Results. There were high prevalences of microalbuminuria (men 22.2 %, women 26.9 %) and of macroalbuminuria (men 10.4 %, women 13.5 %). There were highly statistically significant linear associations of microalbuminuria and macroalbuminuria with increasing number of coexisting components of the metabolic syndrome (hypertension, glucose intolerance, dyslipidaemia, insulin resistance, abdominal obesity): among people with zero, one, two and three to five of these conditions, respectively, prevalence of microalbuminuria was 16 %, 20 %, 36 % and 32 % (p < 0.001); prevalence of macroalbuminuria was 2 %, 6 %, 12 % and 32 % (p < 0.001). There were independent associations of microalbuminuria with hypertension (odds ratio, 95 % confidence interval = 2.36, 1.63–3.42) and diabetes (2.10, 1.28–3.45): macroalbuminuria was independently associated with hypertension (6.39, 3.93–10.4), diabetes (3.49, 1.93–6.28) and abdominal obesity (4.56, 2.40–8.64) and had a weaker association with insulin resistance (1.99, 1.12–3.54). Dyslipidaemia and impaired glucose tolerance were neither independently associated with microalbuminuria or macroalbuminuria, nor was insulin resistance or abdominal obesity independently associated with microalbuminuria.¶Conclusion/interpretation. There was a strong clustering of albuminuria with components of the metabolic syndrome. Diabetes, hypertension and abdominal obesity are major contributors to high rates of albuminuria among Australian Aboriginal people. [Diabetologia (2000) 43: 1397–1403]

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