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Pre-diabetic blood pressure predicts urinary albumin excretion after the onset of Type 2 (non-insulin-dependent) diabetes mellitus in Pima Indians

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Summary

Blood pressure was measured in 490 non-proteinuric Pima Indians from the Gila River Indian Community in Arizona at least 1 year before the diagnosis of Type 2 (non-insulin-dependent) diabetes mellitus. Urine albumin concentration was measured in the same subjects 0–24 years (mean 5 years) after diabetes was diagnosed. Prevalence rates of abnormal albumin excretion (albumin-to-creatinine ratio ≥100 mg/g) after the onset of Type 2 diabetes were 9%, 16%, and 23%, respectively, for the lowest to highest tertiles of pre-diabetic mean blood pressure. When controlled for age, sex, duration of diabetes and pre-diabetic 2-h post-load plasma glucose concentration, higher pre-diabetic mean blood pressure predicted abnormal urinary excretion of albumin after the onset of diabetes. This finding suggests that the higher blood pressure seen in diabetic nephropathy is not entirely a result of the renal disease, but may precede and contribute to it.

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Authors and Affiliations

  1. Department of Biostatistics and Epidemiology, The Cleveland Clinic Foundation, Phoenix, Arizona, USA

    R. G. Nelson & H. R. Baird

  2. Diabetes and Arthritis Epidemiology Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, Arizona, USA

    D. J. Pettitt, M. A. Charles, Q. Z. Liu, P. H. Bennett & W. C. Knowler

  3. Diabetic Renal Disease Study, The Cleveland Clinic Foundation, 1616 East Indian School Road Suite 125, 85016, phoenix, AZ, USA

    R. G. Nelson

Authors
  1. R. G. Nelson
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  2. D. J. Pettitt
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  3. H. R. Baird
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  4. M. A. Charles
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  5. Q. Z. Liu
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  6. P. H. Bennett
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  7. W. C. Knowler
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Nelson, R.G., Pettitt, D.J., Baird, H.R. et al. Pre-diabetic blood pressure predicts urinary albumin excretion after the onset of Type 2 (non-insulin-dependent) diabetes mellitus in Pima Indians. Diabetologia 36, 998–1001 (1993). https://doi.org/10.1007/BF02374490

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