Tags

Type your tag names separated by a space and hit enter

Lowering the threshold for defining microalbuminuria: effects of a lifestyle-metformin intervention in obese "normoalbuminuric" non-diabetic subjects.
Am J Hypertens. 2008 Jan; 21(1):105-10.AJ

Abstract

BACKGROUND

We investigated whether levels of albuminuria (urinary albumin excretion (UAE)) below those conventionally accepted as microalbuminuria (<30 mg/day) are sensitive to correction of obesity and obesity-related risk factors.

METHODS

The effects of a 12-month lifestyle modification-metformin program were evaluated in otherwise healthy overweight/obese "normoalbuminuric" subjects: group I with UAE of <10 mg/day (n = 23) and group II with UAE of 10-29 mg/day (n = 18).

RESULTS

The subjects of group II were older and heavier, and had higher blood pressure (BP) and lower high-density lipoprotein (HDL) levels, than those of group I. Creatinine clearances were also higher in group II (148 +/- 14 ml/min) than in group I (108 +/- 9 ml/min). Although the intervention induced comparable reductions in obesity, BP, lipids and insulin levels in both groups, UAE was significantly reduced in group II (9.1 +/- 1.8 mg/24 h; 60% reduction; P < 0.001), and non-significantly in group I (0.75 +/- 0.5 mg/day; 12% reduction; P > 0.1). Additionally, greater reduction in creatinine clearance was observed in subjects with higher UAE rates. After the intervention, both groups achieved similar UAE rates (5.7 +/- 0.9 and 5.2 +/- 1.0 mg/day; P > 0.10). Basal UAE was related to the subjects' creatinine clearance (r = 0.38; P = 0.04). For both groups together, intervention-induced changes in UAE rates were not significantly related to BP, age, or body weight. However, for group II subjects, BP and UAE reduction were positively associated (r = 0.44; P = 0.03).

CONCLUSIONS

UAE of 10-29 mg/day (hyperalbuminuria), below the conventionally used limit to define microalbuminuria, is already associated with a more adverse cardiovascular risk profile, and is exquisitely sensitive to interventions that reduce obesity, BP, and insulin resistance.

Authors+Show Affiliations

Center for the Detection and Treatment of Silent Risk Factors for Metabolic and Cardiovascular Disease, Division of Clinical Pharmacology, School of Pharmacy, Central University of Venezuela, Caracas, Venezuela. lcubeddu@nova.eduNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18091752

Citation

Cubeddu, Luigi X., et al. "Lowering the Threshold for Defining Microalbuminuria: Effects of a Lifestyle-metformin Intervention in Obese "normoalbuminuric" Non-diabetic Subjects." American Journal of Hypertension, vol. 21, no. 1, 2008, pp. 105-10.
Cubeddu LX, Alfieri AB, Hoffmann IS. Lowering the threshold for defining microalbuminuria: effects of a lifestyle-metformin intervention in obese "normoalbuminuric" non-diabetic subjects. Am J Hypertens. 2008;21(1):105-10.
Cubeddu, L. X., Alfieri, A. B., & Hoffmann, I. S. (2008). Lowering the threshold for defining microalbuminuria: effects of a lifestyle-metformin intervention in obese "normoalbuminuric" non-diabetic subjects. American Journal of Hypertension, 21(1), 105-10.
Cubeddu LX, Alfieri AB, Hoffmann IS. Lowering the Threshold for Defining Microalbuminuria: Effects of a Lifestyle-metformin Intervention in Obese "normoalbuminuric" Non-diabetic Subjects. Am J Hypertens. 2008;21(1):105-10. PubMed PMID: 18091752.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Lowering the threshold for defining microalbuminuria: effects of a lifestyle-metformin intervention in obese "normoalbuminuric" non-diabetic subjects. AU - Cubeddu,Luigi X, AU - Alfieri,Anna B, AU - Hoffmann,Irene S, PY - 2007/12/20/pubmed PY - 2008/3/14/medline PY - 2007/12/20/entrez SP - 105 EP - 10 JF - American journal of hypertension JO - Am J Hypertens VL - 21 IS - 1 N2 - BACKGROUND: We investigated whether levels of albuminuria (urinary albumin excretion (UAE)) below those conventionally accepted as microalbuminuria (<30 mg/day) are sensitive to correction of obesity and obesity-related risk factors. METHODS: The effects of a 12-month lifestyle modification-metformin program were evaluated in otherwise healthy overweight/obese "normoalbuminuric" subjects: group I with UAE of <10 mg/day (n = 23) and group II with UAE of 10-29 mg/day (n = 18). RESULTS: The subjects of group II were older and heavier, and had higher blood pressure (BP) and lower high-density lipoprotein (HDL) levels, than those of group I. Creatinine clearances were also higher in group II (148 +/- 14 ml/min) than in group I (108 +/- 9 ml/min). Although the intervention induced comparable reductions in obesity, BP, lipids and insulin levels in both groups, UAE was significantly reduced in group II (9.1 +/- 1.8 mg/24 h; 60% reduction; P < 0.001), and non-significantly in group I (0.75 +/- 0.5 mg/day; 12% reduction; P > 0.1). Additionally, greater reduction in creatinine clearance was observed in subjects with higher UAE rates. After the intervention, both groups achieved similar UAE rates (5.7 +/- 0.9 and 5.2 +/- 1.0 mg/day; P > 0.10). Basal UAE was related to the subjects' creatinine clearance (r = 0.38; P = 0.04). For both groups together, intervention-induced changes in UAE rates were not significantly related to BP, age, or body weight. However, for group II subjects, BP and UAE reduction were positively associated (r = 0.44; P = 0.03). CONCLUSIONS: UAE of 10-29 mg/day (hyperalbuminuria), below the conventionally used limit to define microalbuminuria, is already associated with a more adverse cardiovascular risk profile, and is exquisitely sensitive to interventions that reduce obesity, BP, and insulin resistance. SN - 0895-7061 UR - https://www.unboundmedicine.com/medline/citation/18091752/Lowering_the_threshold_for_defining_microalbuminuria:_effects_of_a_lifestyle_metformin_intervention_in_obese_"normoalbuminuric"_non_diabetic_subjects_ L2 - https://academic.oup.com/ajh/article-lookup/doi/10.1038/ajh.2007.6 DB - PRIME DP - Unbound Medicine ER -