P152: Microalbuminuria in Newly Diagnosed Diabetes Mellitus: Not Only About Blood Pressure or Arterial Stiffness

Abstract

Background

Diabetes mellitus (DM) and hypertension (EH) are both associated with micro- and macro-vascular damage. Microalbuminuria is a recognized marker of sub-clinical target organ damage in both DM and EH. However, it’s determinants in newly diagnosed DM with or without EH remain unclear.

Methods

We enrolled consecutive newly diagnosed DM patients, recording history, demographics, renal, lipid and glycemic profile, office and ambulatory blood pressure, macro-(pulse-wave velocity/PWV) and micro-vascular (microalbuminuria in 24-hour urine) damage and subclinical atherosclerosis (intima-media thickness).

Results

We studied 65 DM patients (40 male: 25 female, aged 57 ± 11 years), with a median duration from diagnosis of 2 weeks. Their fasting glucose was 121.5 (IR: 36) mg/dl, HbA1c: 7.47 (IR: 2)%. Among them, 26 had already been diagnosed with EH (median duration of 8 (IR: 8) years), while 17 were diagnosed with EH at the time of DM diagnosis. No difference was observed between the two groups, except for significantly higher office and ambulatory BP and PWV in the newly diagnosed EH patients. Microalbuminuria was associated with fasting glucose (p = 0.04), HbA1c (p = 0.002), serum creatinine (p = 0.035), glomerular filtration rate (GFR) (p = 0.002), office systolic (p = 0.009) and diastolic (p = 0.026) BPand PWV (p = 0.031). In the multivariate analysis, HbA1c (beta = 0.351, p = 0.015)was the only determinant of microalbuminuria.

Conclusions

Our study indicates that hyperglycaemia has a significant impact on microalbuminuria even in patients with newly diagnosed DM and EH (either newly diagnosed with high BP values or longer lasting), emphasizing on the need of early and effective glycemic control.