Potential Marker for Increased Cardiovascular Risk Factors in Nondiabetic Subjects?

Microalbuminuria is associated with progression to renal disease In Insulindependent diabetes and wtth Increased mortality in noninsulln-dependent diabetes. In contrast, few studies have addressed the effect of mlcroalbumlnurla on cardiovascular risk In nondlabetics. We, therefore, determined the level of microalbuminuria In 316 nondiabetic subjects from the San Antonio Heart Study, a population-based study of diabetes and cardiovascular risk factors. Microalbuminuria (£30 mg/l) was found In 42 of these 316 subjects (13%). Subjects wtth mlcroalbumlnurla had significantly higher blood pressure, trlglyceride concentration, sum of Insulin concentrations during a glucose tolerance test, and prevalence of hypertension and of self-reported myocardlal Infarction than subjects without microalbuminuria. When subjects with hypertension were excluded (n=27), normotensive subjects with mlcroalbumlnurla (n=31) still had significantly higher trlglyceride concentrations and Insulin sum than normotensive subjects without microalbuminuria (n=258), suggesting that an increased atherogenlc risk factor pattern exists even In normotensive subjects with microalbuminuria. Microalbuminuria may be a marker for cardiovascular risk, although It Is not certain whether microalbuminuria causes these metabolic changes or results from some metabolic disturbance such as insulin resistance. (Arteriosclerosis 10:727-731, September/October 1990)