Borderline Increases in Albumin Excretion Rate and the Relation to Glycemic Control in Subjects with Type I Diabetes

Author:

Chase H Peter1,Marshall Guillermo2,Garg Satish K,Harris Sherrie,Osberg Iris

Affiliation:

1. Department of Pediatrics, University of Colorado Health Sciences Center, Denver CO 80262

2. Address for correspondence: Barbara Davis Center for Childhood Diabetes, 4200 E. 9th Ave., Box B140, Denver, CO 80262

Abstract

Abstract We evaluated "borderline" increases in overnight albumin excretion rates (AERs)—i.e., those between the upper 95th percentile of normal (7.6 μg/min) and the lowest value currently considered predictive of nephropathy (30 μg/min)—to determine their importance and to see whether glucose control influenced subsequent changes in the "borderline" AER values. Between 1985 and 1990, we studied 190 subjects with insulin-dependent diabetes mellitus (Type I), analyzing a mean of 6.5 timed overnight urine samples collected per subject. Above-normal AERs were associated with a significantly (by ANOVA) higher mean age (P = 0.03), longer duration of diabetes (P = 0.0002), and greater mean glycohemoglobin values (P = 0.002). The transition rate between borderline and abnormal AERs was significantly higher (P<0.0001, chi-square test) than the direct transition rate between normal and abnormal AERs, thus showing the borderline AER to be a definite intermediate stage. Good and poor glucose control were clearly associated with improvement and worsening, respectively, of the borderline AER values (P = 0.032, chi-square test of trend). More attention to borderline AER values is clearly indicated.

Publisher

Oxford University Press (OUP)

Subject

Biochemistry, medical,Clinical Biochemistry

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