Low-grade albuminuria in adult and elderly individuals with diabetes mellitus and arterial hypertension accompanied by Primary Health Care

Matheus Augusto Soares De Resende,Tiago Ricardo Moreira,Eunice Ferreira Da Silva,Luma De Oliveira Comini,Clara Regina Santos Batistelli,Heloísa Helena Dias,Daniel Souza Santos,Rosângela Minardi Mitre Cotta,Luiza Delazari Borges,Glauce Dias Da Costa,Rodrigo Gomes Da Silva,Emily De Souza Ferreira

doi:10.1038/s41598-021-96652-6

Matheus Augusto Soares De Resende, Tiago Ricardo Moreira + Show 10 more

Open Access

https://doi.org/10.1038/s41598-021-96652-6

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Journal: Scientific Reports	Publication Date: Sep 2, 2021
License type: open-access

Affiliation: Universidade Federal de Viçosa

Abstract

Diabetes mellitus (DM) and arterial hypertension (AH) are the two main clinical conditions related to Chronic Kidney Disease (CKD); disease also identify by the levels of low-grade albuminuria (LGA). Few studies have simultaneously investigated the associations of glycated hemoglobin (HbA1c) and fasting plasma glucose (FPG) with LGA. Our study aimed to investigate and compare the association of HbA1c and FPG with the probability of LGA in adult and elderly individuals with DM and AH, within the scope of Primary Health Care (PHC). Cross-sectional study involving 737 Brazilians individuals previously diagnosed with hypertension and/or diabetes. Tests for HbA1c, FPG and LGA were performed. LGA was defined as the highest quartile of albumin urinary (≥ 13 mg/g) among individuals with urinary LGA < 30 mg / g. A significant increase in the prevalence of LGA was found with increasing levels of HbA1c (p < 0.001). There was a significant association of HbA1c with LGA (p < 0.001) and increased probability of LGA for participants with HbA1c ≥ 6.5% compared to those with Hba1c < 5.7% (OR [95% CI]: 2.43 [1.32–4.46], p < 0.05), after adjusting for confounding factors, except when adjusted for FPG (p = 0.379 and p = 0.359, respectively). HbA1c and FPG were significantly associated in a collinear manner with an increased probability of LGA in adult and elderly individuals with DM and AH.

Highlights

The low-grade albuminuria (LGA) is considered an important predictor of Chronic Kidney Disease (CKD) and it is categorized as moderately increased albuminuria when its values are between 30 and 300 mg/g and severely increased above 300 mg/g1
Recent evidence shows that LGA, which is when urinary Urine Albumin-toCreatinine Ratio (UACR) values are below the 30 mg/g threshold, is an early marker of cardiovascular m ortality[2], albuminuria values at this level are considered n ormal[1]
Urinary LGA was independently associated with glycated hemoglobin (HbA1c)[3], whose values indicate the mean level of blood glucose in the last 3 months with less variability, despite fasting plasma glucose (FPG) being the test most commonly performed in screening for the diagnosis of diabetes mellitus (DM)[4]

Summary

Introduction

The low-grade albuminuria (LGA) is considered an important predictor of Chronic Kidney Disease (CKD) and it is categorized as moderately increased albuminuria when its values are between 30 and 300 mg/g and severely increased above 300 mg/g1. Urinary LGA was independently associated with glycated hemoglobin (HbA1c)[3], whose values indicate the mean level of blood glucose in the last 3 months with less variability, despite fasting plasma glucose (FPG) being the test most commonly performed in screening for the diagnosis of diabetes mellitus (DM)[4]. There are studies have evaluated the relationship between HbA1c and FPG levels with LGA, in the context of Primary Health Care (PHC) where most patients with DM and AH are diagnosed and accompanied, we have not found many studies. This study aimed to investigate the association between HbA1c and FPG with the probability of LGA in adult and elderly individuals with DM and AH, within the scope of PHC

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