Atherogenic lipids and vascular complications in a selected diabetic population with normal urinary albumin/creatinine ratios.

Objective: To test the hypothesis that at different urinary albumin/creatinine ratios within the normal ranges, diabetics have low but similar prevalence of metabolic and micro vascular disease.

Methods: The study sample consisted of normotensive diabetics not taking any medications known to effect blood pressure and lipids. The data were collected from the Diabetes Register. The diabetics were subgrouped according to the urinary albumin/creatinine ratios. MA is defined as present if the albumin/creatinine ratio (ACR) is more than 2 mg/mmol.

Results: MA was present in 16% of the 152 diabetics. Total cholesterol, systolic BP, and triglycerides were significantly high in diabetics with ACR≥1<2 compared with <1. The prevalence rates for retinopathy and neuropathy in the MA group were also significantly high. However, a large number of diabetics without MA had had established complications (37% retinopathy, 40% neuropathy, and 16% peripheral vascular disease). Because these results were based on single early morning urine samples, we looked at their MA in the past year. After exclusion of regressed and progressed groups, the complications rate remained the same.

Conclusion: The high prevalence of metabolic and vascular complications seen even in absence of MA indicates an early intervention and those diabetics should not wait unitl CVD risk scores raise to receive preventive treatment.