Evaluation of different biochemical markers and imaging modalities in type 2 diabetes mellitus patients with and without albuminuria

Abstract

Objective The aim of this study was to evaluate the effects of albuminuria on different biochemical markers, different target organs, and subclinical atherosclerosis in patients with type 2 diabetes mellitus (T2DM). Patients and methods Sixty T2DM patients were divided into three equal groups according to their levels of albuminuria − namely, normoalbuminuria, microalbuminuria, and macroalbuminuria. Renal function tests, glycemic status markers, serum electrolytes, high-sensitivity C-reactive protein, fibroblast growth factor 23, vitamin D, intact parathyroid hormone, and fractional excretion of phosphate (FePO4) were measured. Patients also underwent renal arterial duplex, Doppler echocardiography, and estimation of the carotid intima–media thickness. Results Blood urea nitrogen and creatinine clearance were significantly higher in patients with albuminuria. Fasting blood glucose, postprandial blood glucose, and glycosylated hemoglobin levels were significantly higher in patients with albuminuria. There were no statistically significant differences among the studied groups as regards serum electrolytes. Fibroblast growth factor 23 levels were significantly higher in patients with albuminuria. In patients with macroalbuminuria, vitamin D levels were significantly lower, whereas intact parathyroid hormone and high-sensitivity C-reactive protein levels were significantly higher. There were no statistically significant differences among the studied groups as regards FePO4. There were no statistically significant differences between the studied groups as regards renal resistive indices, presence or absence of left ventricular hypertrophy, or carotid intima–media thickness. Left ventricular ejection fraction was significantly lower in patients with albuminuria. Conclusion In T2DM patients with albuminuria (especially macroalbuminuria), several markers of renal complications are elevated, denoting a high-risk population for the development of end-stage renal disease. Moreover, markers of asymptomatic left ventricular systolic dysfunction were observed, denoting a higher risk for cardiovascular morbidity and mortality.