Microalbuminuria as a simple predictor of incident diabetes over 8 years in the Korean Genome and Epidemiology Study (KoGES)

Abstract

Microalbuminuria (MAU) is a common subclinical disease and related with cardiovascular outcome both in diabetic and non-diabetic patients. However, there is rare data about the effect of MAU on the development of diabetes. Thus, we aimed to investigate whether MAU is associated with the development of incident diabetes. A total of 3385 subjects without diabetes (1503 men and 1882 women; mean age, 53 years) who participated in the Ansung–Ansan cohort study from 2001–2002 (baseline) to 2011–2012 (fifth follow-up visit) were followed for a mean of 8 years. The prevalence of MAU at baseline was 10.8% (365 patients), and the incidence of newly developed diabetes during the follow-up period was 15.3% (56 patients) in subjects with MAU. The hazard ratio (HR) for development of diabetes was 1.43 (95% confidence interval (CI) 1.07–1.91, p-value 0.016), independent of traditional risk factors for diabetes including pre-diabetes, age, obesity, and family history. The impact of MAU on diabetes was also significant in the non-pre-diabetic population (HR 2.08, 95% CI 1.07–4.03, p-value 0.031). In conclusion, our results show that incident MAU is associated with future development of diabetes and could be an early marker for diabetes, even in the non-prediabetic population.

Association between urinary albumin creatinine ratio and cardiovascular disease

“…Insulin stimulates store-operated Ca entry via Orai-1 channel in podocytes that makes actin remodeling and transepithelial albumin leakage resulting in microalbuminuria [ 35 ]. Recently over 8 years follow up study from Korean Genome and Epidemiology Study (KOGES) showed that microalbuminuria could be used as an early marker of progression to diabetes even in the non-prediabetic population [ 36 ]. Through microalbuminuria we could predict abnormal insulin resistance and diabetes, which were major risk factors for cardiovascular disease [ 37 , 38 ].…”

Metabolically healthy obese individuals are still at high risk for diabetes: Application of the marginal structural model

“…Despite these potential limitations, our results provide valuable insights into the impact of MHO on diabetes development through a causal inference method based on time‐varying exposure. We considered physician diagnosis and medication use to identify as many patients with diabetes as possible, similarly to previous studies 45,46 . Also, results derived from long‐term follow‐up preclude the possibility of early follow‐up bias 11 .…”

Microvascular and Endothelial Dysfunction in Prediabetes

“…There is further evidence that the presence of MAU in prediabetes could be an early indicator for the development of DM. A 10-year cohort study conducted in participants with MAU without DM showed that people with MAU were more likely to develop DM, even after adjustment for the presence of prediabetes [ 75 ]. Similarly, a Chinese cohort study showed that MAU was associated with increased risk of diabetes after a three-year follow-up in populations with normal glucose tolerance and impaired glucose regulation.…”