Naslov
Association of cardiometabolic risk factors with proteinuria in normoalbuminuric diabetic patients

Autori
Božičević, Sandra ; Krhač, Maja ; Matišić, Ena ; Soldo Jureša, Dragica ; Smirčić Duvnjak, Lea ; Vučić Lovrenčić, Marijana

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
23rd IFCC-EFLM European Congress of Clinical Chemistry and Laboratory Medicine / Delanghe, Joris ; Wu, Alan H - Amsterdam : Elsevier, 2019, S287-s287

Skup
23rd IFCC-EFLM European Congress of Clinical Chemistry and Laboratory Medicine (EUROMEDLAB 2019)

Mjesto i datum
Barcelona, Španjolska, 19.05.2019. - 23.05.2019

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
cardiometabolic risk factors ; proteinuria ; normoalbuminuric diabetic patients

Sažetak
Background-aim. Regular assessment of albuminuria has been a recommended tool for screening and diagnosis of chronic kidney disease (CKD) in diabetic patients for decades. Proteinuria was incorporated into risk stratification and staging of CKD by 2012 Kidney Disease Improving Global Outcome (KDIGO) guidelines. Our previous research revealed a discordance between albuminuria and proteinuria, with elevated protein- to-creatinine ratio (PCR) in a substantial proportion of diabetic patients with normal albumin-to- creatinine ratio (ACR). The aim of this study was to examine the relationship between the A2 (PCR range: 15-50 mg/mmol) class of proteinuria and cardiometabolic risk biomarkers in patients with diabetes and normoalbuminuria (ACRb3, 0 mg/mmol). Methods. We retrospectively analysed results for 347 selected diabetic patients (M/F=165/182) with normal urinary sediment, normoalbuminuria and eGFR-based (CKD-EPI equation) CKD stages 2-4. ACR and PCR were calculated from albumin, protein and creatinine in random urine. Serum uric acid, triglycerides (TG), total-, HDL-, LDL- and VLDL-cholesterol were quantified with routine laboratory methods. All urine and serum measurements were performed on Beckman Coulter AU680 analyser. HbA1c was measured with immunoturbidimetric method on Roche Integra 400Plus analyser. Results. ACR and PCR levels were 1, 8±0, 74 and 18, 0±3, 11 mg/mmol. Glycaemic control, at HbA1c cut-off 53 mmol/mol had no influence on either measure of proteinuria (P=0, 1011 for ACR and P=0, 267 for PCR), whereas the existence of CKD, as assessed by eGFR 60 ml/ min/1, 73m2 (N=68) was accompanied with significantly higher uric acid, TG and PCR (P=0, 001, 0, 0133 and b0, 001), but not ACR levels (P=0, 541), respectively. Stepwise linear regression analysis revealed that PCR was significantly positively associated with ACR and TG (r=0, 1431 and 0, 1702 ; P=0, 009 and 0, 0019) and negatively with eGFR and VLDL-cholesterol (r=-0, 2569 and -0, 2203 ; Pb0, 001 and 0, 001). Conclusions. Our study indicates that PCR may serve as a valuable additional diagnostic tool in identifying incipient kidney damage in diabetic patients with normal ACR. Independent association between PCR and TG/VLDL-cholesterol suggest a distinct role of dyslipidemia in the development of CKD in diabetes.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA