Proteinuria as a significant predictive factor for the progression of carotid artery atherosclerosis in non-albuminuric type 2 diabetes

Published:October 07, 2021DOI:https://doi.org/10.1016/j.diabres.2021.109082

      Highlights

      • A high urine protein-to-creatinine ratio may be a useful and early predictive marker for the progression of carotid artery atherosclerosis , even in patients with type 2 diabetes and without albuminuria.
      • A high urine protein-to-creatinine ratio may be an earlier indicator of DKD development than albuminuria, suggesting renal tubulopathy.
      • A retrospective study included 927 participants with type 2 diabetes and without albuminuria.

      Abstract

      Aims

      This study aimed to evaluate the clinical significance of urine protein to creatinine ratio (uPCR) in relation to the cardiovascular risk associated with carotid artery intima-media thickness (cIMT) progression in subjects with type 2 diabetes (T2D) and normoalbuminuria.

      Methods

      In this retrospective longitudinal study on T2D, we recruited 927 participants with normoalbuminuria (urine albumin to creatinine ratio [uACR] < 30 mg/g) whose cIMT was measured at baseline and after at least 1 year, and whose initial uPCR and uACR data were available.

      Results

      Higher initial uPCR was positively correlated with a greater increment in maximal cIMT (β = 0.074, p = 0.028), and this correlation was significant even after adjusting for multiple confounding factors (β = 0.074, p = 0.046). High baseline uPCR was an independent predictive factor for the increased risk of maximal cIMT progression in a simple logistic regression model (OR, 1.41; 95% CI, [1.08–1.86]; p = 0.013). Even after adjusting for several confounding variables, higher uPCR was significantly associated with a higher risk of cIMT progression (OR, 1.48; 95% CI, [1.08–2.03]; p = 0.014).

      Conclusions

      These results suggest that high uPCR may be a useful predictive marker for the progression of carotid artery atherosclerosis, even in subjects with T2D and without albuminuria.

      Keywords

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