Incidence of overt proteinuria and coronary artery disease in patients with type 2 diabetes mellitus: the role of microalbuminuria and retinopathy

Received in revised form 4 January 2004; accepted 6 January 2004.

Abstract

The 5-year incidence of coronary artery disease (CAD) and progression to overt proteinuria was investigated in patients with type 2 diabetes mellitus who had microalbuminuria with (MA+R group, n=93) or without (MA−R group, n=138) diabetic retinopathy. The rate of progression to overt proteinuria was higher in the MA+R group than in the MA−R group. The MA−R group had more components of metabolic syndrome than the MA+R and normoalbuminuric (NA, n=205) groups. The MA−R group had a higher 5-year incidence of CAD than the NA group. The incidence of CAD tended to be higher in the MA−R group than in the MA+R group, but statistical significance was not reached. The present study shows that patients with diabetic retinopathy and microalbuminuria represent a group with incipient diabetic nephropathy having higher risk for progression to overt proteinuria. On the other hand, patients with microalbuminuria and no retinopathy may represent a group with characteristics of metabolic syndrome.

Abbreviations: CVD, cardiovascular disease, CAD, coronary artery disease, UAE, urinary albumin excretion, BP, blood pressure, BMI, body mass index, HDL, high-density lipoprotein, ACE, angiotensin converting enzyme, AIIRB, angiotensin II receptor blocker

Keywords: Diabetes mellitus, Microalbuminuria, Diabetic retinopathy, Diabetic nephropathy, Coronary artery disease

Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Pungnap 2-dong, Songpa-gu, Seoul, 138-736, South Korea

Corresponding author. Tel.: +82-2-3010-3243; fax: +82-2-3010-6962.

PII: S0168-8227(04)00019-1

doi:10.1016/j.diabres.2004.01.001

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