Coronary heart disease and urinary albumin excretion rate in Type 2 (non-insulin-dependent) diabetic patients

Mattock, M. B.; Keen, H.; Viberti, Gian Carlo; El-Gohari, M. R.; Murrells, Trevor; Scott, Graham S.; Wing, J. R.; Jackson, P.

doi:10.1007/bf00395552

Cited by 174 publications

(95 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Other classic cardiovascular risk factors were also associated with coronary heart disease in this study, and these include micro-or macroalbuminuria or both, which are well established as independent cardiovascular risk factors in NIDDM [36]. Plasma total cholesterol and apoB levels were also significantly associated with coronary heart disease in our patients, despite the more frequent use of hypolipidaemic treatment in the CHD + group.…”

Section: Discussionsupporting

confidence: 52%

Association of elevated lipoprotein(a) levels and coronary heart disease in NIDDM patients. Relationship with apolipoprotein(a) phenotypes

et al. 1994

View full text Add to dashboard Cite

Summary Non-insulin-dependent diabetes mellitus (NIDDM) is a strong and independent risk factor for coronary heart disease. We assessed the potential relationship between plasma Lp(a) levels, apo(a) phenotypes and coronary heart disease in a population of NIDDM patients. Seventy-one patients with coronary heart disease, who previously have had transmural myocardial infarction, or significant stenosis on coronary angiography, or positive myocardial thallium scintigraphy, or in combination, were compared with 67 patients without coronary heart disease, who tested negatively upon either coronary angiography, myocardial thallium scintigraphy or a maximal exercise test. The prevalence of plasma Lp(a) levels elevated above the threshold for increased cardiovascular risk ( > 0.30 g/l) was significantly higher (p = 0.005) in patients with coronary heart disease (33.8 %) compared to the control group (13.4%). The relative risk (odds ratio) of coronary heart disease among patients with high Lp(a) concentrations was 3.1 (95 % confidence interval, 1.31-7.34;p = 0.01). The overall frequency distribution of apo(a) phenotypes differed significantly between the two groups (p = 0.043). However, the frequency of apo(a) isoforms of low apparent molecular mass ( < 700 kDa) was of borderline significance (p = 0.067) between patients with or without coronary heart disease (29.6 % and 16.4 %, respectively). In this Caucasian population of NIDDM patients, elevated Lp(a) levels were associated with coronary heart disease, an association which was partially accounted for by the higher frequency of apo(a) isoforms of small size. In multivariate analyses, elevated levels of Lp(a) were independently associated with coronary heart disease (odds ratio 3.48, p = 0.0233). [Diabetologia (1994) 37: 585-591] Key words NIDDM, lipoprotein(a), apo(a) isoforms, coronary heart disease, lipids, lipoproteins, cardiovascular risk factors.Non-insulin-dependent diabetes mellitus (NIDDM) is a strong and independent risk factor for cardiovascular and coronary heart disease mortality [1]. Established risk factors, including glucose intolerance, arterial hypertension, central obesity, hypercholesterolaemia or hypertriglyceridaemia, have been shown to contrib-

show abstract

Section: Discussionsupporting

confidence: 52%

Association of elevated lipoprotein(a) levels and coronary heart disease in NIDDM patients. Relationship with apolipoprotein(a) phenotypes

et al. 1994

View full text Add to dashboard Cite

show abstract

“…Hypertension is a risk factor of cardiovascular events in Type 2 diabetic patients with microalbuminuria [38]. It seems established that high blood pressure in these patients should be adequately controlled, regardless its pathophysiological mechanism(s) behind the development of hypertension.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the renal effects of angiotensin converting enzyme inhibitor and calcium antagonist in hypertensive Type 2 (non-insulin-dependent) diabetic patients with microalbuminuria: a randomised controlled trial

1989

View full text Add to dashboard Cite

Summary. Seven of eight hypertensive Type 2 (non-insulindependent) diabetic patients with microalbuminuria completed a randomised crossover trial to compare the renal effects of angiotensin converting enzyme inhibitor (enalapril) and calcium antagonist (nicardipine). Four-week fixed oral maintenance dosages of enalapril (10-20 rag/day) and nicardipine (60-120 rag/day) significantly (p<0.05) lowered the systolic and diastolic blood pressures without altering renal blood flow, glomerular filtration rate and filtration fraction. Both drugs significantly reduced (p< 0.05) urinary albumin excretion rate and fractional clearance of albumin to similar extents. Total renal vascular resistance decreased significantly by nicardipine (p<0.05) and non-significantly by enalapril. Plasma osmotic pressure, plasma aldosterone concentration, total serum protein concentration, serum electrolytes and HbAlc remained unchanged by these drugs, whereas plasma renin activity was significantly higher (/7<0.05) in the enalapril than in the control and nicardipine phases. These results suggest that both drugs have similar renal function preserving effects with a concomitant hypotensive action in hypertensive Type 2 diabetic patients with microalbuminuria, and that the angiotensin converting enzyme inhibitor may not have advantageous renal effects when compared to the calcium antagonist and vice versa. Both drugs might be useful for treatment of high blood pressure in hypertensive diabetic patients, if long-term studies of these drugs can be shown to benefit the patients over other conventional antihypertensive therapies.

show abstract

“…3,4 Moreover, in people with NIDDM, it is associated with other risk factors for CVD such as hypertension, 3±7 hyperglycaemia, 3±7 obesity, 3,6 and dyslipidaemia. 3 Studies of elderly non-diabetic subjects in the general population have also shown a positive relationship between degree of albuminuria and increased CVD morbidity, 7 early mortality, 7,8 and risk factors for CVD. 9±16 These observations led Yudkin,7 Cruickshank 17 and Haffner 9 to propose that microalbuminuria might represent a marker of CVD risk in nondiabetic subjects.…”

Section: Introductionmentioning

confidence: 99%

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

Metcalf

Scragg

Dryson³

1997

Int J Obes

View full text Add to dashboard Cite

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.

show abstract

Coronary heart disease and urinary albumin excretion rate in Type 2 (non-insulin-dependent) diabetic patients

Cited by 174 publications

References 17 publications

Association of elevated lipoprotein(a) levels and coronary heart disease in NIDDM patients. Relationship with apolipoprotein(a) phenotypes

Association of elevated lipoprotein(a) levels and coronary heart disease in NIDDM patients. Relationship with apolipoprotein(a) phenotypes

Comparison of the renal effects of angiotensin converting enzyme inhibitor and calcium antagonist in hypertensive Type 2 (non-insulin-dependent) diabetic patients with microalbuminuria: a randomised controlled trial

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

Contact Info

Product

Resources

About