Study of Microalbuminuria in subjects with Type 2 Diabetes with Ischemic heart disease in Rural population in South India

Indumathi Shankaraiah, Harish Kiran N.E.


Objectives: Ischemic heart disease (IHD) is the frequent causes of morbidity and mortality worldwide. The prevalence of ischemic heart disease in general population being 2-4%, while in people with type 2 diabetes 9.9% .This study was conducted at Subbaiah Medical College & Research Institute, Shimoga to Study Microalbuminuria in subjects with Type 2 Diabetes mellitus with Ischemic heart disease and without Ischemic heart disease, to assess the cardiovascular health status and to take appropriate steps to prevent further morbidity

Methods: We studied 100 patients admitted to Medical wards after meeting the required criteria following investigations was carried out.

1) 12 Lead ECG 2) Spot urine albumin creatinine ratio 3) FBS & PPBS 4) Blood urea and serum creatinine 5) TMT / 2D ECHO 6) Lipid profile.

Results: 100 subjects were included, 59% were males and remaining 41% were females.50 subjects were having Type 2 Diabetes with IHD considered as cases, other 50 subjects were having Type 2 Diabetes without IHD considered as controls. Among patients with IHD, maximum UACR value is 276 and minimum value is 20, whereas in patients without IHD, maximum is 42 and minimum is 18.There is significant difference in the mean UACR among patients with and without IHD.

T-statistics -7.73 indicates statistically significant with p-value of <0.001 at 5% significance level.

Conclusion: Subjects with Type 2 DM with IHD have been found to have higher UACR levels than those subjects without IHD. Screening for UACR can help clinicians estimate a patient's CVD risk and to take appropriate steps to prevent further morbidity.


Ischemic heart disease (IHD), Microalbuminuria, UACR [urine albumin creatinine ratio], Type 2 diabetes mellitus.

Full Text:



. Fauci AS, Braunwald E, Kasper DL, Hauser SL, Longo DL, Jameson JL, et al., Editors. Harrisons principles of internal medicine: Ischemic Heart Disease. 18th Ed. New York: McGraw Hill; 2001. p. 1998.

. Nyuyen TT, Elleform RD, Hodge DO, Balles KR, Kolthe TE, Abu-Leddhl. Lp (a) as a risk factor for cardiovascular disease. Circulation 1997; 96: 1390-7.

. Ridker PM, Cushman M, Stampfer MJ, Tracy RP, Hennekens CH. Inflammation, aspirin, and the risk of cardiovascular disease in apparently healthy men. N Engl J Med 1997; 336: 9739.

. Ridker PM, Hennekens CH, Buring JE, Rifai N. C-reactive protein and other markers of inflammation in the prediction of cardiovascular disease in women. N Engl J Med 2000; 342: 83643.

. MA J, Hennekens CH, Ridker PM, Stampfer MJ. A prospective study of fibrinogen and risk of myocardial infarction in the Physicians Health Study. J Am Coll Cardiol 1999; 33:1347-52.

. De Zeeuw D, Remuzzi G, Parving HH, Keane WF, Zhang Z, Shahinfar S, Snapinn S, Cooper ME, Mitch WE, Brenner BM: Albuminuria, a therapeutic target for cardiovascular protection in type 2 diabetic patients with nephropathy. Circulation 2004; 110: 921927.

. Fauci AS, Braunwald E, Kasper DL, Hauser SL, Longo DL, Jameson JL, et al. Harrisons principles of internal medicine: Ischemic Heart Disease. 18th ed. New York: McGraw Hill; 2001: 2985-86.

. Ali I, Khan I, Baloch MK, Mustafa G. Comparative lipid profile studies in cardiac and diabetic patients. Pak J Pharmaceut Sci 2004; 17: 25-30.

. Parving HH, Osterby R, Ritz E. Diabetic nephropathy. In: Brenner BM, Levine S (edi). The Kidney. Philadelphia: WB Saunders; 2000:1731-73.

. Garg JP, Bakris GL. Microalbuminuria: marker of cardiovascular dysfunction, risk factor for cardiovascular disease. Vasc Med 2002; 7:35-43.

. Hillege HL, Janssen WMT, Bak AAA, Diercks GFH, Grobbee DE, Crijns HJGM et al. Microalbumniuria is common, also in a nondiabetic, nonhypertensive population, and an independent indicator of cardiovascular risk factors and cardiovascular morbidity. J Inter Med 2001; 249:519-26.

. Welty TK, Lee ET, Yeh J, Cowan LD, Fabsitz RR, Oopik AJ, et al. Cardiovascular disease risk factors among American Indians. The Strong Heart Study. Am. J. Epidemiol. 1995, 142, 269287.

. Kannel WB, McGee DL. Diabetes and cardiovascular disease: The Framingham study. JAMA 1979; 241: 2035-2038.

. Mogensen CE, Chachati A, Christensen CK, Close CF, Deckert T, Hommel E, et al. Microalbuminuria: an early marker of renal involvement in diabetes. Uremia Invest 1985-1986; 9: 85-95.

. National Kidney Foundation: KDOQI clinical practice guidelines and clinical practice recommendations for diabetes and chronic kidney disease. Am J Kidney Dis 2007; 49: (Suppl1) S180.

. Valmadrid CT, Klein R, Moss SE, Klein BE. The risk of cardiovascular disease mortality associated with microalbuminuria and gross proteinuria in persons with older onset diabetes mellitus. Arch Intern Med 2000; 160: 1093-110.

. Karalliedde J, Viberti G: Microalbuminuria and cardiovascular risk. AMJ Hypertension 2004; 17: 986993.

. Liu JE, Robbins DC, Palmieri V, Bella JN, Roman MJ, Fabsitz R, Howard BV, Welty TK, Lee ET, Devereux RB: Association of albuminuria with systolic and diastolic left ventricular dysfunction in type 2 diabetes: The Strong Heart Study. Coll Cardiol 2003; 41: 20222028.

. De Zeeuw D, Remuzzi G, Parving HH, et al. Micro-albuminuria as an early marker for cardiovascular disease. JASN. 2006; 17(8): 2100-2105.

. Brantsma AH, Bakker SJ, de Zeeuw D, de Jong PE, Gansevoort RT. Urinary albumin excretion as a predictor of the development of hypertension in the general population. J AM Soc Nephrol 2006; 17: 331-335.

. Romundstad S, Holmen J, Kvenild K, Hallan H, Ellekjaer H. Microalbuminuria and all-cause mortality in 2,089 apparently healthy individuals: a 4.4-year follow-up study. The Nord-Trondelag Health Study (HUNT), Norway. Am J Kidney Dis 2003; 42:466-473.

. Tuttle KR, Puhlman ME, Cooney SK, Short R: Urinary albumin and insulin as predictors of coronary artery disease: An angiographic study. AM J Kidney Disease 1999; 34: 918925.

. Brantsma AH, Bakker SJ, Hillege HL, de Zeeuw D, de Jong PE, Gansevoort RT: Urinary albumin excretion and its relation with C-reactive protein and the metabolic syndrome in the prediction of type 2 diabetes. Diabetes care 2005; 28: 25252530.



  • There are currently no refbacks.

Copyright (c) 2017 International Journal of Biomedical Research

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.