Association between microalbuminuria and cardiovascular disease in type 2 diabetes mellitus of the Beijing Han nationality

Abstract

The objective of this study is to investigate the correlation of urinary albumin excretion rate (UAER) with the incidence of coronary heart disease (CHD), pathological characteristics and severity of coronary atherosclerosis in patients with type 2 diabetes mellitus (T2DM), and explore the efficacy of using the urinary albumin excretion rate (UAER) to predict the risk of CHD in patients with T2DM. The study included 1,004 T2DM patients with normo- and micro-albuminuria who underwent coronary angiography for suspected coronary atherosclerosis. The severity of coronary atherosclerosis was defined using the Gensini's score system. The correlation of UAER with the incidence of CHD, pathological characteristic and the severity of coronary atherosclerosis in patients with T2DM was analyzed. The best numerical value of UAER in predicting the risk of CHD in patients with T2DM was calculated. The differences in sex, age, BMI, SBP, history of smoking, duration of diabetes mellitus, HbA1C, FPG, LDL-C, HDL-C, Cre, Uric acid, HOMA-IR between microalbuminuria(MAU) subgroup and normal albuminuria subgroup were statistically significant(P < 0.05). The differences in the incidence of CHD, the number of pathological coronary vessels, the Gensini's score and LVEF% between microalbuminuria group and normal albuminuria group were statistically significant (P < 0.05). UAER increased significantly with an increase in the number of pathological coronary vessels. Logistic multiple regression analysis showed that UAER was independently correlated with the incidence of CHD (OR = 1.092, P = 0.000, 95% CI = 1.063-1.122). Spearman's correlation analysis showed that the Gensini's score was significantly positively correlated with UAER, sex, age, BMI, SBP, the history of smoking and drinking, the duration of diabetes mellitus, HbA1c, FPG, PPG, LDL-C, Cre, C-reactive protein (CRP), uric acid (UA). Based on the ROC curve, the 11.275 μg/min of UAER was the best numerical value to predict the risk of CHD in patients with T2DM. Area under the curve was 0.799, sensitivity was 65.1%, and specificity was 82.9%.

Conclusion: Microalbuminuria in patients with T2DM is another risk factor for CHD. Microalbuminuria is significantly positively correlated with the severity of coronary atherosclerosis. An UAER value of 11.275 μg/min can be used to predict the risk of CHD in patients with T2DM.