부산대학교 도서관

Microalbuminuria (MA) and Macroalbuminuria (MAA) are independent cardio-renal risk factors. Aim of this study was to evaluate factors associated with progression or regression of MA/MAA in a cohort of individuals with DM2. A random sample of 1289 patients aged 18-80 years was recruited by 55 Italian diabetes clinics. A morning spot urine sample was collected to measure albumin/creatinine ratio (ACR) and to detect urinary infections. Patients were re-evaluated after one year. Overall, 1019 were included in the analyses, while 211 were excluded for urinary infections and 59 because of incomplete information. At baseline, 18.8% of the patients had MA (ACR=30-299 mg/g), while 3.2% had MAA. The rate of regression was of 40.5%, mainly from MA to normoalbuminuria (NA) (86.7%). The rate of progression was of 10.2%: from NA to MA in 72.3% of cases, from NA to MAA in 10.9%, and from MA to MAA in 16.8% of cases. At multivariate logistic regression, treatment with ACE-Inhibitors and/or ARBs at baseline (OR=2.1, 95%IC 1.04-4.3) or its initiation during the study (OR=2.50, 95%IC 1.02-6.1) were the strongest correlates of regression. Variables associated with progression were: baseline systolic blood pressure (OR=l.08, 95%IC 1.00-1.16), increase in waist circumference during the year (OR=1.04, 95%IC 1.01-1.08), and diabetes duration (OR=1.04, 95%IC 1.01-1.07). In conclusion, the progression of MA/MAA is associated with modifiable risk factors, such as hypertension and abdominal obesity. Treatment with ACE-Inhibitors or ARBs is associated with a marked increase in the likelihood of regression of albuminuria. [ABSTRACT FROM AUTHOR]