High-normal urinary albumin-to-creatinine ratio is independently associated with metabolic syndrome in Chinese patients with type 2 diabetes mellitus: A cross-sectional community-based study

Abstract

Aims/introduction: Microalbuminuria is positively related to metabolic syndrome (MetS). Our aim was to investigate whether urinary albumin-to-creatinine ratio (UACR) within the normal range is independently associated with MetS in Chinese community-based patients with type 2 diabetes.

Materials and methods: A total of 514 participants (206 males and 308 females; mean age 66 years) with UACR less than 3.5 mg/mmol were enrolled from two downtown areas of Shanghai. The participants were stratified into quartiles according to UACR levels. The prevalence of MetS was assessed and compared among the four groups by binary logistic regression.

Results: Compared with participants with UACRs in the first quartile, the other quartiles had a higher prevalence of MetS (65.9%, 74.4% and 81.3%, respectively, P = 0.001) after adjustment for sex and age. After adjusting for potential confounders, participants in the second to the fourth quartile group had a 1.36-, 1.84- and 2.73-fold risk of MetS, respectively, relative to those in the lowest quartile. Furthermore, UACR, whether as quartile groups or as a continuous variable, is an independent predictor of MetS after fully adjusting for other variables.

Conclusions: These results suggest that UACR even within the normal range is independently associated with MetS in Chinese community-based patients with type 2 diabetes mellitus.

Keywords: Metabolic syndrome; Type 2 diabetes mellitus; Urinary-to-albumin creatinine ratio.

Figure 1

(a) Comparison of the prevalence of metabolic syndrome (MetS) among urinary albumin-to-creatinine ratio (UACR) quartiles. The P-value for four group comparisons was 0.001. (b) Differential UACR level among participants with MetS-related components. P = 0.001 for trend of elevated UACR level with increasing number of MetS-related components. (c) Comparison of the prevalence of MetS stratified by sex among three groups after adjusting for age. The P-value for four group comparisons in men and women was 0.336 and 0.005, respectively. (d) Comparison of the prevalence of MetS stratified by age among the four groups after adjusting for sex. The P-value for the four group comparisons in middle-aged people and old-aged people was 0.131 and 0.014.