Factors Responsible for Progression of Microalbuminuria in Japanese Patients with Type 2 Diabetes-Retrospective Analysis

Abstract

Aim: This study was designed to investigate factors associated with progression or remission of microalbuminuria (MA) in Japanese type 2 diabetes (T2D). Subjects and Methods: T2D patients with MA, defined as urinary albumin/Cre ratio (UACR) 30-299 mg/gCre, were retrospectively screened from medical records of 65,323 patients who visited Kansai Electric Power Hospital between 20and 2009 (baseline period); and their status of MA was re-evaluated between 2014 and 2017 (evaluation period) using mean values of multiple measurements of UACR or urinary protein/Cre ratio (UPCR). Data were analyzed using χ2 test, ANOVA and logistic regression analysis. Result: T2D patients with MA identified in the baseline period (n=155) had 3 different outcomes in the evaluation period: Group A (n=26; UACR <30 mg/gCre), group B (n=106; UACR 30-299 mg/gCre) and group C (n=23; UACR >300 mg/gCre or UPCR >500 mg/gCre). Mean and standard deviation (SD) of HbA1c during the observation period differ significantly among different groups in the evaluation period (Table 1), despite of the similar baseline age, BMI, T2D duration and HbA1c. Mean and SD HbA1c also associated with MA (Mean OR 2.18 (95% CI; 1.23-3.88), SD OR 9.91 (95% CI: 2.57-38.2)). Conclusion: Sustained glycemic control is the critical to prevent MA progression in Japanese T2D.Table 1. Glycemic control and use of drugs during the observation period.GroupABCP valuen(M/F)26(20/6)106(76/30)23(16/7)Mean HbA1c(%)7.44±0.117.39±0.067.88±0.130.014Standard deviation of HbA1c during total observation period(%)0.51±0.050.58±0.020.77±0.070.013Antihypertensive drug use (%)73.170.895.70.043Lipid-lowering drug use (%)73.178.369.6n.s.Antiplatelet drug use (%)19.232.129.6n.s. Disclosure S. Kubota: None. H. Kuwata: None. D. Yabe: Speaker's Bureau; Self; MSD K.K., Novo Nordisk Pharma Ltd., Takeda Pharmaceutical Co., Ltd., Taisho Toyama Pharmaceutical Co., Ltd.. Research Support; Self; Nippon Boehringer Ingelheim Co. Ltd., Eli Lilly and Company, MSD K.K., Ono Pharmaceutical Co., Ltd., Arkray, Inc., Taisho Toyama Pharmaceutical Co., Ltd., Novo Vordisk Pharma Ltd., Takeda Pharamaceutical Co., Ltd.. K. Murotani: None. Y. Hamamoto: None. T. Kurose: Consultant; Self; Sanofi, Ono Pharmaceutical Co., Ltd.. Other Relationship; Self; Abbott. Consultant; Self; Taisho Pharmaceutical Co., Ltd.. Other Relationship; Self; Takeda Pharmaceutical Co., Ltd., Merck Sharp & Dohme Corp., Novo Nordisk Inc., Novartis Pharma K.K. Y. Seino: Speaker's Bureau; Self; MSD K.K., Kao Corporation, Taisho Pharmaceutical Co., Ltd., Nippon Boehringer Ingelheim Co. Ltd., Taisho Toyama Pharamceutical Co., Ltd., Takeda Pharmaceutical Co., Ltd., Nippon Becton Dickinson Co., Ltd., Novo Nordisk Pharma Ltd.. Research Support; Self; Terumo Medical Corporation, Bayer Yakuhin, Ltd., Boehringer Ingelheim GmbH, Arkray, Inc., Ono Pharmaceutical Co., Ltd., Sumitomo Dainippon Pharma Co., Ltd., Taisho Toyama Pharmaceutical Co., Ltd., Novo Nordisk Pharma Ltd..