1.
Association of microalbuminuria and high-normal 24-hour urinary albumin excretion with metabolic syndrome and its components in the general Chinese population: cross-sectional study.
Xu, J, Ma, J, Chen, X, Yan, L, Cai, X, Guo, X, Zhang, Y, Wu, J
BMJ open. 2019;(11):e031443
Abstract
OBJECTIVE Microalbuminuria (MAU) has been described as a risk factor for metabolic syndrome (MetS). However, the association between MetS components with MAU and 24-hour urinary albumin excretion (UAE) has not been clearly explained in the general Chinese population. We aimed to analyse the associations between MAU and high-normal 24-hour UAE with MetS and its components. DESIGN Cross-sectional observational study. SETTING Four selected counties/districts in China's Shandong and Jiangsu Provinces. PARTICIPANTS A total of 2261 participants aged 18-69 years were included in this study. Participants with missing physical examination data or incomplete urine collection were not included in the analysis. RESULTS The prevalence of MAU was 9%, and the mean 24-hour UAE was 18 mg/d. The prevalence of MAU was significantly higher for the MetS, high blood pressure (BP), high triglyceride (TG) levels, low high-density lipoprotein cholesterol (HDL-C) and hyperglycaemia groups but not for the central obesity group. Both MAU and mean 24-hour UAE were significantly increased in association with a number of MetS components. The adjusted prevalence OR (POR) for MetS with MAU was 2.95 (95% CI 2.15 to 4.04) compared with those without MAU. MAU was significantly associated with three components of MetS: high BP (POR=1.86, 95% CI 1.31 to 2.64), high TG levels (POR=1.80, 95% CI 1.31 to 2.46) and hyperglycaemia (POR=1.84, 95% CI 1.34 to 2.53). No significant association between MAU and central obesity or low HDL-C was found. The presence of MetS gradually increased according to the normal-range 24-hour UAE quartiles: POR=1.00, POR=1.22, POR=1.14 and POR=2.02, respectively. Hyperglycaemia also increased significantly according to the normal-range 24-hour UAE quartiles. CONCLUSIONS MAU and elevated 24-hour UAE within the normal range were closely associated with MetS in the Chinese population, which may provide a basis for the development of early interventions to decrease the effects of MetS.
2.
[The effect of perindopril in treatment of early diabetic nephropathy with normal blood pressure and microalbuminuria].
Yao, B, Hu, G, Li, Y, Liao, Z, Zhang, Y
Zhonghua nei ke za zhi. 2001;(12):826-8
Abstract
OBJECTIVE To study the effect of perindopril in decreasing the urinary albumin excretion rate (AER) and protecting the renal function in normotensive early diabetic nephropathy. METHODS 52 diabetic patients with AER between 20 to 200 microg/min, were treated with dietary regimen, oral antihyperglycemic agents or/ and insulin till their fasting blood glucose (FBG) was < 7.0 mmol/L and postprandial blood glucose (PBG) < 10.0 mmol/L. They were then divided randomly into two groups. Group A was a control group (25 cases), the patients were administered with placebo, group B was a treatment group (27 cases), the patients were administered with perindopril (4 mg/day) FBG, PBG, glycosylated haemoglobin A1c (HbA1c), AER, blood pressure (MAP) and blood creatinine (Cr) were examined immediately and 3, 6, 12 and 18 months after the treatment. RESULTS In group A, AER was significantly increased after 12 and 18 months than at beginning, they were (52.3 +/- 8.6) microg/min and (60.4 +/- 9.0) microg/min vs (44.2 +/- 6.8) microg/min (P < 0.05). In group B, after being treated with perindopril, AER estimated 3, 6, 12 and 18 months later were (20.3 +/- 5.6) microg/min, (22.1 +/- 6.1) microg/min, (21.3 +/- 5.9) microg/min and (20.8 +/- 5.7) microg/min respectively, all were significantly lower those that of group A in the same period (P < 0.05) and also significantly lower than those at the beginning (P < 0.05). CONCLUSION Perindopril has good effects in decreasing AER in normotensive early diabetic nephropathy and in protecting the renal function.