Association of urinary albumin-to-creatinine ratio with cardiometabolic risk markers and pre-diabetes in adults with normoglycemia, normoalbuminuria, and normotension with parental type 2 diabetes

Matthew Everett, Natasha Rushing,Peace Asuzu,Jim Wan,Samuel Dagogo-Jack

BMJ OPEN DIABETES RESEARCH & CARE(2024)

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摘要
Introduction: This is a post hoc analysis of urinary albumin-to-creatinine ratio (uACR) within the normoalbuminuric range in relation to cardiometabolic risk factors among initially normoglycemic, normotensive participants in the Pathobiology of Prediabetes in a Biracial Cohort (POP-ABC) Study. Research design and methods: 308 healthy African American (AA) and European American (EA) participants in the POP-ABC Study underwent baseline assessments, including oral glucose tolerance test, anthropometry, urinary albumin-to-creatinine ratio (uACR), lipids, adipocytokines, insulin sensitivity and secretion. Participants were followed quarterly for 5.5 years (mean 2.62 years) for the primary outcome of incident pre-diabetes. Results: The cohort's mean fasting glucose was 92.1 +/- 6.90 mg/dL, 2-hour plasma glucose was 123 +/- 25.0 mg/dL, systolic blood pressure was 123 +/- 15.9 mm Hg, and diastolic blood pressure was 74 +/- 8.80 mm Hg. Baseline uACR levels (range 1-29 mg/g) were similar in AA versus EA participants (6.40 mg/g +/- 4.80 vs 6.80 +/- 5.40 mg/g, p=0.52), higher in women than men (7.30 mg/g +/- 5.30 vs 4.60 +/- 3.90 mg/g, p<0.0001), and showed significant associations with cardiometabolic risk factors, including age, insulin sensitivity, high-density lipoprotein cholesterol, and adiponectin levels (p=0.03-0.004). During 5.5 years of follow-up, 104 participants developed pre-diabetes and 204 maintained normoglycemia. Baseline uACR quartiles were associated with incident pre-diabetes (r=0.19, p=0.0011). Conclusions: Baseline uACR levels were associated with cardiometabolic risk markers and incident pre-diabetes risk among adults with normoglycemia, normoalbuminuria and normotension with parental diabetes.
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关键词
Albuminuria,Impaired Fasting Glucose,Impaired Glucose Tolerance,Ethnic Groups
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