Prevalence of Microalbuminuria and Relationship to the Risk of Cardiovascular Disease in the Japanese Population

Abstract

The prevalence of microalbuminuria and its relationship to cardiovascular disease risk factors were examined in subjects participating in an annual physical and laboratory examination program. The urinary albumin concentration and the urinary albumin/creatinine ratio were determined in morning urine specimens. A turbidimetric immunoassay was used for the measurement of urinary albumin. Of the 731 subjects, 41 (5.6%) who were weakly positive or positive on a routine dipstick test for protein were excluded from the final analysis of data. Microalbuminuria was present in 14.5% of the men, in 12.4% of the women, and in 13.2% of the entire subject population when defined as a urinary albumin concentration of 30–299 μg/ml. The prevalence of microalbuminuria was significantly higher in subjects with a high normal blood pressure (15.0%) or hypertension (26.2%) as compared with normotensive subjects (6.5%). Subjects with impaired glucose tolerance (24.3%) or hyperglycemic subjects (50.0%) had a significantly higher prevalence of microalbuminuria than normoglycemic subjects (11.3%). The prevalence of microalbuminuria was significantly higher in subjects with left ventricular hypertrophy (47.1%) as compared with those with normal electrocardiograms (11.3%). A good correlation was observed between urinary albumin concentration and albumin/creatinine ratio, and both showed a significant positive correlation with age, systolic and diastolic blood pressures, and fasting plasma glucose, total serum protein, albumin, and triglyceride levels, but not with angiotensin-converting enzyme activity. Multiple regression analysis demonstrated that both the urinary albumin concentration and the albumin/creatinine ratio show a significant positive correlation with systolic blood pressure and fasting plasma glucose. The prevalence of microalbuminuria was about 13% in this Japanese cohort, and the systolic blood pressure and the fasting plasma glucose level were demonstrated as independent risk indicators for both urinary microalbumin level and urinary microalbumin/creatinine ratio.

Establishment of a Method to Detect Microalbuminuria by Measuring the Total Urinary Protein-to-Creatinine Ratio in Diabetic Patients

“…Because early-stage CKD is unlikely to be symptomatic and because microalbuminuria is not reliably detectable using routine dipstick methods, CKD remains unidentified in many patients. However, the prevalence of microalbuminuria is reported to be high (around 13-14%) in the Japanese general population (Tomura et al 1999;Konta et al 2006). The rates of proteinuria according to the results of the urine dipstick test are only one-third as high as those for microalbuminuria (Konta et al 2006).…”

The Prevalence and Risk Factors of Microalbuminuria in Hypertensive Patients under Current Medical Treatment

“…This finding suggests that the early stage of CKD is often overlooked and therefore is clinically underdiagnosed. The reported prevalence of MAU in hypertensive populations exceeds that observed in the general population (12)(13)(14)(18)(19)(20). However, the prevalence of MAU in hypertensive patients is highly variable among studies, with a range of 26.6 to 58.4% (14,19,20).…”

Microalbuminuria, an integrated marker of cardiovascular risk in essential hypertension

“…Not surprisingly, therefore, essential hypertensive patients with microalbuminuria frequently showed either mild fasting hyperglycaemia or a hyperglycaemic response to oral glucose loading. [63][64][65][66][67][68][69][70][71][72] Since a worse glucose tolerance is part of the so-called metabolic syndrome X, 73 slight elevations in UAE were also associated with its typical phenotypes, ie, hyperinsulinaemia, [63][64][65][66][67][68][69][70][71][72]74 insulin resistance, 67,68 high triglycerides and low high-density lipoprotein (HDL), 25,75,76 overweight-obesity 18,77,78 and BP sensitivity to increased sodium intake. 79 Increased concentrations of total and low-density lipoprotein (LDL)-cholesterol sometimes reported in hypertensive patients with microalbuminuria 3 have raised the intriguing possibility of a link between microalbuminuria and atherogenic lipids unrelated to the trait of the syndrome X, but the results of large-scale studies 14,18 seem to contradict that possibility.…”