MON-287 CORRELATION OF HBA1c AND URINE ALBUMIN CREATININE RATIO (UACR) WITH RENAL AND CARDIOVASCULAR HEALTH RISK FACTORS IN PATIENTS WITH DIABETES MELLITUS

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Renal and cardiovascular comorbidity are important risk factor for overall mortality in both Type 1 and 2 diabetes mellitus (DM) patients. Poor blood glucose control has an unfavourable impact on complications. It is also believed that development of kidney disease in these patients worsens cardiovascular risk. To better ameliorate these major vascular complications we have tried to study the correlation of HbA1c and UACR (two easily measured biomarkers) with modifiable clinical and biochemical parameters in DM patients. Both these biomarkers have the potential to facilitate prevention and management of several specific aspects of diabetes mellitus patients. A prospective observational cohort study was conducted between July 2015 and June 2018 in our clinic. All type 1 and 2 diabetes mellitus patients who consented to be part of this investigative trial were included. The presence of hypertension on clinical evaluation was noted. Conventional diabetes biomarkers (hemoglobin, HbA1c, serum creatinine / eGFR; serum lipid profile, serum albumin, urine albumin creatinine ratio.) were tested in the cohort.Correlation between HbA1c and UACR with clinical and laboratory biomarkers were studied. A total of 1077 patients were evaluated. There were 61% males. Of these 260 were of type 1 diabetes mellitus and 817 were type 2 DM patients .Hypertension (a major cardiovascular and renal risk factor) was significantly associated not only with high HbA1c and high UACR but also with renal functions (creatinine, eGFR) and poor glucose control in this cohort. Table 1. The biomarker HbA1c was significantly correlated positively with urine albumin creatinine ratio (nephropathy), serum total cholesterol (poor glycemic control).It was negatively correlated with serum albumin (nephropathy – albuminuria) and serum creatinine (preexisting impaired renal function, tight glycemic control and hypoglycemia).A high UACR was significantly (a) positively correlated with HbA1c (poor glycemic control), and (b) negatively correlated with hemoglobin (anemia of CKD). Table 2. Table 1Correlation of hypertension with biochemical factorsHypertensionHemoglobin (g/dl)HbA1c %Albumin g/dlUACR mcg/mgCreatinine mg/dleGFR ml/minHTN -12.99.73.8410.6121HTN+12.28.53.72671.555p value0.070.040.250.00000.00000.0000 Open table in a new tab Table 2Correlation between HbA1c and UACR with other biochemical parametersBiochemical ParameterHbA1c (%) R2 P valueUACR (mcg/mg) R2 P valueUACR mcg/mgR2 =+ 0.16P value= 0.0001-----------HbA1c (%)---------------R2=0.16P value =0.0001Hemoglobin (g/dl)R2= 0.07 P value =0.07R2= - 0.16P value 0.0001Serum Albumin (g/dl)R2= -0.13 P value =0.002R2= -0.26P value 2.2Creatinine (mg/dl)R2= -0.14 P value =0.001R2=0.23P value=4.2eGFR ml/min/1.73m2R2=0.26 P value = 9.6R2= -0.19P value =4.4Cholesterol (mg/dl)R2=0.13 P value = 0.004R2=0.03P value=0.48Triglycerides (mg/dl)R2=0.18 P value =2.9R2=0.04P value =0.26 Open table in a new tab Utilising easily available biomarkers(HbA1c and UACR) for risk prediction of cardiovascular and renal complications in DM patients may be a feasible approach in resource limited setting.