The Australian Medical Association Limited and state AMA entities comply with the Privacy Act 1988. Please refer to the AMA Privacy Policy to understand our commitment to you and information on how we store and protect your data.

×

Search

×

Diabetes: even normal urinary protein excretion has its risks

An Italian study suggests that, in people with type 2 diabetes, any degree of measurable urinary protein excretion – even in what is considered the normal range – increases their risk of experiencing cardiac health problems. It is known that type 2 diabetes patients suffering albuminaria have a considerably higher risk of developing heart problems than other diabetics and people in the general population (normoalbuminuric) with urinary albumin excretion levels of less than 20 μg/min. Since normoalbuminuria patients account for such a high proportion of all diabetics, health researchers have long wondered if any level of excretion might increase risk of heart problems.

16 Sep 2012

An Italian study suggests that, in people with type 2 diabetes, any degree of measurable urinary protein excretion – even in what is considered the normal range – increases their risk of experiencing cardiac health problems.

It is known that type 2 diabetes patients suffering albuminaria have a considerably higher risk of developing heart problems than other diabetics and people in the general population (normoalbuminuric) with urinary albumin excretion levels of less than 20 ?g/min. Since normoalbuminuria patients account for such a high proportion of all diabetics, health researchers have long wondered if any level of excretion might increase risk of heart problems.

A group of researchers at the Mario Negri Institute for Pharmacological Research and the Ospedale Riunti in Bergamo set out to evaluate the relationship between albumin excretion levels and heart problems by following about 1,200 normoalbuminuric patients with type 2 diabetes over an average of 9.2 years.

They found that any degree of measurable albumin excretion bore significant risk of heart problems. There was a progressive incremental risk of heart problems during follow-up for each 1 ?g/min in albumin excretion at the start of the study. Even albuminaria of 1-2 ?g/min, compared with <1 ?g/min, was significantly associated with increased risk.

When they investigated only the subgroup of patients in the study who were taking ACE inhibitors from the start to the end of the study, they found no link between excretion levels and heart risks, suggesting that ACE inhibitors have heart-protective properties that may benefit both albuminuric and normoalbuminuric patients.

They say that more clinical trials are needed to identify levels of albumin excretion above which this cardio-protective therapy would be beneficial.

Their study has been accepted for publication in the Journal of the American Society of Nephrology.

DN


Published: 16 Sep 2012