Factors affecting levels of urinary albumin excretion in the general population of Spain: the Di@bet.es study

Abstract

The present study was undertaken to examine the prevalence of urinary ACR (albumin/creatinine ratio) >30 mg/g and the associated clinical and environmental factors in a representative sample of the population of Spain. Di@bet.es study is a national, cross-sectional population-based survey conducted in 2009-2010. Clinical, metabolic, socio-demographic, anthropometric data and information about lifestyle habit were collected. Those subjects without KDM (known diabetes mellitus) were given an OGTT (oral glucose tolerance test). Albumin and creatinine were measured in a urinary sample and ACR was calculated. The population prevalence of ACR >30 mg/g was 7.65% (adjusted for sex and age). The prevalence of ACR >30 mg/g increased with age (P<0.001). Subjects with carbohydrate metabolism disorders had a greater prevalence of ACR >30 mg/g but after being adjusted for age, sex and hypertension, was significant only in those subjects with UKDM (unknown diabetes mellitus) {OR (odd ratio), 2.07 [95% CI (confidence interval), 1.38-3.09]; P<0.001] and KDM [OR, 3.55 (95% CI, 2.63-4.80); P<0.001]. Prevalence of ACR >30 mg/g was associated with hypertension [OR, 1.48 (95% CI, 1.12-1.95); P=0.001], HOMA-IR (homoeostasis model assessment of insulin resistance) [OR, 1.47 (95% CI, 1.13-1.92); P≤0.01], metabolic syndrome [OR, 2.17 (95% CI, 1.72-2.72); P<0.001], smoking [OR, 1.40 (95% CI, 1.06-1.83); P≤0.05], physical activity [OR, 0.68 (95% CI, 0.54-0.88); P≤0.01] and consumption of fish [OR, 0.38 (95% CI, 0.18-0.78); P≤0.01]. This is the first study that reports the prevalence of ACR >30 mg/g in the Spanish population. The association between clinical variables and other potentially modifiable environmental variables contribute jointly, and sometimes interactively, to the explanation of prevalence of ACR >30 mg/g. Many of these risk factors are susceptible to intervention.

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“…We decided to include in this work the measurement of following parameters in a selected group: glycated haemoglobin (HbA1c) [4][5][6][7], high-sensitivity C-reactive protein (hs-CRP) [8][9][10], thyrotropin (TSH) [11][12][13][14], microalbuminuria [15][16][17], especially for their good cost-efficiency and easy accessibility.…”

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“…Studies on urine albumin are therefore associated with diseases or analysis based on explaining the situation. For examples, studies on the excretion of urine albumin 93,94 and studies on the relationship with white blood cell count 95 and iron sucrose 96 can be given. In this dataset, gender and age are demographic measurements, the remaining ones are health‐related laboratory measurements.…”

“…Studies on urine albumin are therefore associated with diseases or analysis based on explaining the situation. For examples, studies on the excretion of urine albumin 93,94 and studies on the relationship with white blood cell count 95 and iron sucrose 96…”