Dysglycemia but not lipids is associated with abnormal urinary albumin excretion in diabetic kidney disease: a report from the Kidney Early Evaluation Program (KEEP)

<p>Abstract</p> <p>Background</p> <p>The relationship between glycemic control and lipid abnormalities with urinary albumin-creatinine ratio (ACR) in chronic kidney disease (CKD) patients with diabetes mellitus (DM) is unknown. We sought to investigate the association o...

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Main Authors: Bose Subhasish, Bomback Andrew S, Mehta Nehal N, Chen Shu-Cheng, Li Suying, Whaley-Connell Adam, Benjamin Joseph, McCullough Peter A
Format: Article
Language:English
Published: BMC 2012-09-01
Series:BMC Nephrology
Subjects:
Online Access:http://www.biomedcentral.com/1471-2369/13/104
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spelling doaj-56b3a20370fb4fc0ab2b54c3a3fd2a192020-11-24T23:07:38ZengBMCBMC Nephrology1471-23692012-09-0113110410.1186/1471-2369-13-104Dysglycemia but not lipids is associated with abnormal urinary albumin excretion in diabetic kidney disease: a report from the Kidney Early Evaluation Program (KEEP)Bose SubhasishBomback Andrew SMehta Nehal NChen Shu-ChengLi SuyingWhaley-Connell AdamBenjamin JosephMcCullough Peter A<p>Abstract</p> <p>Background</p> <p>The relationship between glycemic control and lipid abnormalities with urinary albumin-creatinine ratio (ACR) in chronic kidney disease (CKD) patients with diabetes mellitus (DM) is unknown. We sought to investigate the association of dyslipidemia and glycemic control with levels of albuminuria in the National Kidney Foundation (NKF) Kidney Early Evaluation Program (KEEP) participants with DM and CKD stage 3 or higher.</p> <p>Methods</p> <p>We performed a cross-sectional study of 6639 eligible KEEP patients with DM and CKD Stage 3 to 5 from June 2008 to December 2009. Multivariate logistic regression was used to evaluate the association of lipid parameters (per 10 mg/dl change in serum level) and glycosylated hemoglobin (HbA1c) values with three degrees of albuminuria normo (<30 mg⁄g), micro (30 to 300 mg⁄g) and macro (>300 mg⁄g).</p> <p>Results</p> <p>2141 KEEP participants were included. HbA1c levels were strongly associated with micro-albuminuria (compared to normo-albuminuria) and macro-albuminuria (compared to normo-albuminuria and micro-albuminuria). Each 1.0% increase in HbA1c increased the odds of micro-albuminuria by 32% (OR 1.32, 95% CI 1.23-1.42) and the odds of macro-albuminuria (vs. microalbuminuria) by 16% (OR 1.16, 95% CI 1.05-1.28). Only increases in serum HDL were associated with decreased odds of micro-albuminuria; otherwise, the association between other components of the serum lipid profile with urinary ACR did not reach statistical significance.</p> <p>Conclusion</p> <p>In this cross-sectional study of 2141 KEEP participants with DM and CKD stages 3–5, overall glycemic control but not lipids were associated with abnormal urinary albumin excretion, a marker of increased risk for progressive disease.</p> http://www.biomedcentral.com/1471-2369/13/104Chronic Kidney DiseaseDiabetes MellitusProteinuriaDyslipidemiaGlycosylated hemoglobin
collection DOAJ
language English
format Article
sources DOAJ
author Bose Subhasish
Bomback Andrew S
Mehta Nehal N
Chen Shu-Cheng
Li Suying
Whaley-Connell Adam
Benjamin Joseph
McCullough Peter A
spellingShingle Bose Subhasish
Bomback Andrew S
Mehta Nehal N
Chen Shu-Cheng
Li Suying
Whaley-Connell Adam
Benjamin Joseph
McCullough Peter A
Dysglycemia but not lipids is associated with abnormal urinary albumin excretion in diabetic kidney disease: a report from the Kidney Early Evaluation Program (KEEP)
BMC Nephrology
Chronic Kidney Disease
Diabetes Mellitus
Proteinuria
Dyslipidemia
Glycosylated hemoglobin
author_facet Bose Subhasish
Bomback Andrew S
Mehta Nehal N
Chen Shu-Cheng
Li Suying
Whaley-Connell Adam
Benjamin Joseph
McCullough Peter A
author_sort Bose Subhasish
title Dysglycemia but not lipids is associated with abnormal urinary albumin excretion in diabetic kidney disease: a report from the Kidney Early Evaluation Program (KEEP)
title_short Dysglycemia but not lipids is associated with abnormal urinary albumin excretion in diabetic kidney disease: a report from the Kidney Early Evaluation Program (KEEP)
title_full Dysglycemia but not lipids is associated with abnormal urinary albumin excretion in diabetic kidney disease: a report from the Kidney Early Evaluation Program (KEEP)
title_fullStr Dysglycemia but not lipids is associated with abnormal urinary albumin excretion in diabetic kidney disease: a report from the Kidney Early Evaluation Program (KEEP)
title_full_unstemmed Dysglycemia but not lipids is associated with abnormal urinary albumin excretion in diabetic kidney disease: a report from the Kidney Early Evaluation Program (KEEP)
title_sort dysglycemia but not lipids is associated with abnormal urinary albumin excretion in diabetic kidney disease: a report from the kidney early evaluation program (keep)
publisher BMC
series BMC Nephrology
issn 1471-2369
publishDate 2012-09-01
description <p>Abstract</p> <p>Background</p> <p>The relationship between glycemic control and lipid abnormalities with urinary albumin-creatinine ratio (ACR) in chronic kidney disease (CKD) patients with diabetes mellitus (DM) is unknown. We sought to investigate the association of dyslipidemia and glycemic control with levels of albuminuria in the National Kidney Foundation (NKF) Kidney Early Evaluation Program (KEEP) participants with DM and CKD stage 3 or higher.</p> <p>Methods</p> <p>We performed a cross-sectional study of 6639 eligible KEEP patients with DM and CKD Stage 3 to 5 from June 2008 to December 2009. Multivariate logistic regression was used to evaluate the association of lipid parameters (per 10 mg/dl change in serum level) and glycosylated hemoglobin (HbA1c) values with three degrees of albuminuria normo (<30 mg⁄g), micro (30 to 300 mg⁄g) and macro (>300 mg⁄g).</p> <p>Results</p> <p>2141 KEEP participants were included. HbA1c levels were strongly associated with micro-albuminuria (compared to normo-albuminuria) and macro-albuminuria (compared to normo-albuminuria and micro-albuminuria). Each 1.0% increase in HbA1c increased the odds of micro-albuminuria by 32% (OR 1.32, 95% CI 1.23-1.42) and the odds of macro-albuminuria (vs. microalbuminuria) by 16% (OR 1.16, 95% CI 1.05-1.28). Only increases in serum HDL were associated with decreased odds of micro-albuminuria; otherwise, the association between other components of the serum lipid profile with urinary ACR did not reach statistical significance.</p> <p>Conclusion</p> <p>In this cross-sectional study of 2141 KEEP participants with DM and CKD stages 3–5, overall glycemic control but not lipids were associated with abnormal urinary albumin excretion, a marker of increased risk for progressive disease.</p>
topic Chronic Kidney Disease
Diabetes Mellitus
Proteinuria
Dyslipidemia
Glycosylated hemoglobin
url http://www.biomedcentral.com/1471-2369/13/104
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