Microalbuminuria and obesity: impact on cardiovascular disease and mortality.

Objective: Microalbuminuria and obesity are both associated with cardiovascular disease (CVD). The aim of this study was to determine the association between obesity (measured by body mass index, waist-to-hip ratio, waist circumference) and different levels of microalbuminuria. We also aimed to determine the risk of death and CVD at different levels of microalbuminuria and obesity.

Design: Population-based observational study based on 2696 men and women, 30-70 years of age. Urinary albumin excretion (UAE), body mass index, waist-to-hip ratio, waist circumference and other cardiovascular risk factors were measured during the years 1992-1994 at the Copenhagen City Heart Study. End-points were registered until 1999-2000 with respect to CVD and until 2004 with respect to death.

Results: There was a strong association between microalbuminuria and obesity. Microalbuminuria and obesity had additive effects on the relative risk of death independently of other risk factors. In contrast there was no statistically significant association between microalbuminuria and risk of CVD when stratified by obesity.

Conclusions: Microalbuminuria (UAE > 5 microg/min) confers increased risk of death and to a similar extent as obesity. This effect is independent of concomitant obesity. We suggest microalbuminuria to be included in health examinations besides measurements of obesity.