, Volume 53, Issue 1, pp 49-57,
Open Access This content is freely available online to anyone, anywhere at any time.
Date: 30 Oct 2009

Determinants of urinary albumin excretion within the normal range in patients with type 2 diabetes: the Randomised Olmesartan and Diabetes Microalbuminuria Prevention (ROADMAP) study

Abstract

Aims/hypothesis

In contrast to microalbuminuric type 2 diabetic patients, the factors correlated with urinary albumin excretion are less well known in normoalbuminuric patients. This may be important because even within the normoalbuminuric range, higher rates of albuminuria are known to be associated with higher renal and cardiovascular risk.

Methods

At the time of screening for the Randomised Olmesartan and Diabetes Microalbuminuria Prevention (ROADMAP) Study, the urinary albumin/creatinine ratio (UACR) was 0.44 mg/mmol in 4,449 type 2 diabetic patients. The independent correlates of UACR were analysed.

Results

Independent correlates of UACR during baseline were (in descending order): night-time systolic BP (r s = 0.19); HbA1c (r s = 0.18); mean 24 h systolic BP (r s = 0.16); fasting blood glucose (r s = 0.16); night-time diastolic BP (r s = 0.12); office systolic BP, sitting (r s = 0.11), standing (r s = 0.10); estimated GFR (r s = 0.10); heart rate, sitting (r s = 0.10); haemoglobin (r s = −0.10); triacylglycerol (r s = 0.09); and uric acid (r s = −0.08; all p ≤ 0.001). Significantly higher albumin excretion rates were found for the following categorical variables: higher waist circumference (more marked in men); presence of the metabolic syndrome; smoking (difference more marked in males); female sex; antihypertensive treatment; use of amlodipine; insulin treatment; family history of diabetes; and family history of cardiovascular disease (more marked in women).

Conclusions/interpretation

Although observational correlations do not prove causality, in normoalbuminuric type 2 diabetic patients the albumin excretion rate is correlated with many factors that are potentially susceptible to intervention.

Trial registration:

ClinicalTrials.gov ID no.: NCT00185159

Funding:

This study was sponsored by Daichii-Sankyo.

An erratum to this article can be found at http://dx.doi.org/10.1007/s00125-009-1623-1