Cohort study of predictive value of urinary albumin excretion for atherosclerotic vascular disease in patients with insulin dependent diabetes

Torsten Deckert, Hiroki Yokoyama, Elisabeth Mathiesen, Birgitte Rønn, Tonny Jensen, Bo Feldt-Rasmussen, Knut Borch-Johnsen, Jan Skov Jensen*

*Corresponding author af dette arbejde

    Publikation: Bidrag til tidsskriftArtikelForskningpeer review

    Abstract

    Objective - To examine whether slightly elevated urinary albumin excretion precedes development of atherosclerotic vascular disease in patients with insulin dependent diabetes independently of conventional atherogenic risk factors and of diabetic nephropathy. Design - Cohort study with 11 year follow up. Setting - Diabetes centre in Denmark. Subjects - 259 patients aged 19-51 with insulin dependent diabetes of 6-34 years' duration and without atherosclerotic vascular disease or diabetic nephropathy at baseline. Main outcome measures - Baseline variables: urinary albumin excretion, blood pressure, smoking habits, and serum concentrations of total cholesterol, high density lipoprotein cholesterol, sialic acid, and von Willebrand factor. End point: atherosclerotic vascular disease assessed by death certificates, mailed questionnaires, and hospital records. Results - Thirty patients developed atherosclerotic vascular disease during follow up of 2457 person years. Elevated urinary albumin excretion was significantly predictive of atherosclerotic vascular disease (hazard ratio 1.06 (95% confidence interval 1.02 to 1.18) per 5 mg increase in 24 hour urinary albumin excretion, P = 0.002). Predictive effect was independent of age; sex; blood pressure; smoking; serum concentrations of total cholesterol, high density lipoprotein cholesterol, sialic acid, and von Willebrand factor; level of haemoglobin A(1c); insulin dose; duration of diabetes; and diabetic nephropathy (hazard ratio 1.04 (1.01 to 1.08) per 5 mg increase in 24 hour urinary albumin excretion, P = 0.03). Conclusion - Slightly elevated urinary albumin excretion independently predicted atherosclerotic vascular disease in patients with insulin dependent diabetes.

    OriginalsprogEngelsk
    Sider (fra-til)871-874
    Antal sider4
    TidsskriftBritish Medical Journal
    Vol/bind312
    Udgave nummer7035
    StatusUdgivet - 16 apr. 1996

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