Prevalence of microalbuminuria and its associated cardiometabolic risk factors in Korean youth: Data from the Korea National Health and Nutrition Examination Survey

Abstract

Background: Microalbuminuria is a known early predictive factor for renal and cardiovascular diseases, not only for patients with diabetes mellitus or hypertension but also in the general population. However, the prevalence and risk factors associated with microalbuminuria in Korean youth are unknown.

Objectives: The aims of this study are to evaluate the prevalence of microalbuminuria and the association between microalbuminuria and obesity or cardiometabolic risk factors in Korean children and adolescents without diabetes.

Methods: This study examines data obtained from the Korea National Health and Nutrition Examination Survey (between 2011 and 2014). It includes a total of 1,976 participants aged between 10 and 19 years (boys 1,128 and girls 848). Microalbuminuria was defined as a urine albumin-to-creatinine ratio (UACR) of ≥ 30 mg/g and < 300 mg/g. Association between microalbuminuria and the risk factors for cardiometabolic diseases including insulin resistance was evaluated.

Results: The prevalence of microalbuminuria was found to be 3.0% in Korean children and adolescents over this time period. The mean UACR for non-obese youth was significantly greater than that found in obese youth (3.2 ± 0.1 mg/g in the non-obese group vs. 2.1 ± 0.2 mg/g in the obese group; P < 0.001). In multiple logistic regression analysis, microalbuminuria was associated with hyperglycemia (OR 2.62, 95% CI 1.09-6.30) and hemoglobin A1c (OR 3.34, 95% CI 1.09-10.17) in the non-obese group and hypertension (OR 14.10, 95% CI 1.12-177.98) and HbA1c (OR 6.68, 95% CI 1.87-23.95) in the obese group.

Conclusions: The prevalence of microalbuminuria is not prominent in obese children and adolescents. Our findings demonstrated that the presence of hypertension and hyperglycemia was associated with microalbuminuria. Especially Hemoglobin A1c was associated with microalbuminuria in youths regardless of weight status. Microalbuminuria in pediatric population can be a helpful marker for the risk of cardiovascular disease.

Fig 1. Flow chart of eligible study population.

Fig 2. Distribution of urinary albumin-to-creatinine ratio by body mass index category.

Fig 3. The relationship between the log-transformed urinary albumin-to-creatinine ratio (mg/g creatinine) and body mass index SDS (coefficient = -0.19, P < 0.001).