Associations between body morphology and microalbuminuria in healthy middle-aged European, Maori and Pacific Island New Zealanders

Abstract

OBJECTIVE: To examine the relationship between albuminuria and measures of body morphology. DESIGN: Cross-sectional study of European, Maori and Paci®c Island workers aged 40 y and over. SUBJECTS: 3960 non-diabetic, non-hypertensive, non-lipidaemic, non-proteinuric middle-aged men and women. MEASUREMENTS: Height, weight, waist, hip, fasting and 2 h glucose, systolic and diastolic blood pressure, urinary creatinine and urinary albumin measurements. RESULTS: After adjusting for age and gender, the relative risks (95% con®dence interval) of microalbuminuria were 4.87-fold (3.10±7.64) higher in Maori, and 4.96-fold (3.40±7.24) higher in Paci®c Islanders compared to European New Zealanders. In contrast, age and gender adjusted relative risks (95% con®dence interval) for high albumin:creatinine ratios were 6.38 (4.27, 9.53) in Maori and 5.14 (3.54, 7.48) in Paci®c Islanders compared to European workers. Workers with microalbuminuria had higher urinary creatinine concentrations than those with urinary albumin in the normal range. Age and gender adjusted partial correlation coef®cients between urinary albumin concentrations and the inverse of urinary creatinine concentrations were highest in European and Maori workers. Apart from Paci®c Islanders, urinary creatinine concentrations accounted for over 20% of the variation in urinary albumin concentrations in healthy individuals. Other independent predictors of urinary albumin concentrations were waist measurements, short stature and body mass index in Europeans and Paci®c Islanders, and systolic blood pressure levels and gender in Europeans. After adjusting for age, gender, waist, height, 2 h glucose, urinary creatinine, systolic blood pressure and body mass index Maori and Paci®c Islanders still had signi®cantly higher urinary albumin concentrations than Europeans. CONCLUSION: Urinary creatinine concentrations were signi®cantly associated with urinary albumin concentrations in all ethnic groups, and, with the exception of Paci®c Islanders, accounted for a large proportion of the variation in urinary albumin concentrations in healthy individuals. Urinary albumin concentrations were associated with measures of obesity and short stature in Europeans and Paci®c Islanders, and systolic blood pressure levels and gender in Europeans. However, measures of body morphology did not completely explain the higher urinary albumin concentrations in Maori or Paci®c Islanders.

Predictors of Preeclampsia in Women in the Metformin in Gestational Diabetes(Mig) Study

“…Healthy middle aged Polynesian people have previously been shown to have higher rates of microalbuminuria and increased urinary protein forms part of the diagnostic criteria for PE. In the current study, Polynesian women had marginally higher urine albumin: creatinine ratio on enrolment but this was not different from the other ethnic groups [8][9][10]16]. It could be postulated that higher early pregnancy BMI and higher fasting glucose at enrolment underlie the influence of Polynesian ethnicity.…”

Abdominal obesity, systolic blood pressure, and microalbuminuria in normotensive and euglycemic Korean men

“…Similarly, several studies have suggested a differential effect according to body morphology. [15][16][17][18][19][20] The prevalence of MA among the study subjects was lower than that reported for a study of the general population. [5][6][7] This is expected following the selection criteria for the study.…”

“…[9][10][11] Studies of glucose-tolerant subjects suggested that IR is not always associated with MA. [12][13][14] Some studies suggested that abdominal obesity is independently associated with MA, [15][16][17][18][19][20] whereas others showed that abdominal obesity is not related to the albuminuria level. 12,13 The latter studies may have been biased by factors such as a small sample size and the former studies did not exclude subjects with high-normal blood pressure or hypertension.…”

Adipose tissue, insulin action and vascular disease: inflammatory signals

“…Many of the features that have been ascribed to the metabolic syndrome are more common in obese subjects, including dyslipidaemia, hypertension, elevations in levels of plasminogen activator inhibitor-1 3 and fibrinogen, 5 and microalbuminuria. 7 Furthermore, manifestations of endothelial dysfunction, such as impaired responses to endothelial nitric oxidemediated vasodilators 8 and to shear stress, 9 are found in obese subjects, improving with weight loss. 10 These observations suggest the existence of adipose-generated signals, which influence not only insulin action in skeletal muscle, and both insulin action and acute-phase activation in the liver, but also modulate endothelial cell function in conduit and resistance vessels and in capillaries.…”