Coronary Artery Disease Associated With Low-Grade Albuminuria in Type 2 Diabetes Mellitus

Microalbuminuria can be measured in 24-hour urine samples for early detection of patients at high risk of developing vascular complications. The present study investigated the relation between vascular disease and normal levels of urinary albumin. The prevalence of coronary artery disease (CAD) and diabetic retinopathy (DR) was investigated in 145 patients with type 2 diabetes who had normal renal function. The patients were classified according to levels of microalbuminuria (normal ≤ 14 mg/24 hr, high-normal > 14 mg/24 hr to < 30 mg/24 hr). The association between CAD and DR and various patient parameters were investigated, including sex, age, time of diagnosis, family history of diabetes, smoking habits, body mass index, abdominal circumference, high blood pressure, absence of nocturnal blood pressure fall as registered by ambulatory 24-hour monitoring, retinopathy, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, and glycosylated hemoglobin. The overall prevalence of CAD was 24.0% and that of DR was 18.3% among the 142 patients. A trend was observed toward an association of CAD with age > 60 years (p = 0.08) and family history of hypertension (p = 0.058). A significant association was found between CAD and high-normal microalbuminuria (relative risk 2.79; 95% confidence interval 1.88−4.16; p < 0.001). DR was statistically associated with female sex (p = 0.028) and duration of diagnosis > 5 years (p = 0.022). DR displayed a tendency for association with an absence of nocturnal blood pressure fall (p = 0.067), but was not statistically associated with either of the two levels of microalbuminuria (p = 0.657). CAD is significantly associated with the level of microalbuminuria > 14 mg/24 hr. The presence of DR could not be statistically associated with high-normal levels of microalbuminuria.