The Association Between Urinary Albumin to Creatinine Ratio and Coronary Artery Calcification in Type 2 Diabetic Patients

Ju Young Lee, Yeon-Kyung Choi, H. Seo, Jae-Han Jeon, Jung Eun Lee, S. Moon, J. G. Kim, Bo-Wan Kim, I.-K. Lee
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Abstract

Background: Atherosclerosis, the most commo n cause of death in type 2 diabetic patients, is closely associated with coronary artery calcium deposition. The coronary calcifications can be easily measured using coronary calcium scoring computed tomography (CT). And microalbuminuria is known as an independent risk factor of cardiovascular disease. So, we examined the association of urinary albumin to creatinine ratio (UACR) and coronary calcification score (CCS) in type 2 diabetic patients. Methods: Among type 2 diabetic patients who underwent the multidetector CT scanning for the evaluation of CCS at Kyungpook National University Hospital between December 2007 and May 2008, 155 subjects were included. CCS, demographic and laboratory data were assessed. Results: Coronary artery calcifications were identified in 90 patients (51%) and mean, median CCS was 205.8 ± 476.9, 8.74 (0, 132.0). 60 subjects revealed UACR greater than 30 ug/mg. With the UACR increment, CCS revealed a significant increase (P < 0.001). Age, duration of diabetes, serum Apo A1 level, serum high sensitivity C-reactive protein (hs-CRP) level were also associated with CCS. However, after adjusting for age, UACR and CCS exhibited a significant positive relationship (P = 0.002). Conclusion: Increased UACR is associated with coronary artery calcification in type 2 diabetic patients and these results will be useful in early evaluating the presence of macrovascular complications in these patients. (Korean Diabetes J 33:289-298, 2009)
2型糖尿病患者尿白蛋白/肌酐比值与冠状动脉钙化的关系
背景:动脉粥样硬化是2型糖尿病患者最常见的死亡原因,与冠状动脉钙沉积密切相关。冠状动脉钙化可以很容易地用冠状动脉钙化评分计算机断层扫描(CT)来测量。微量白蛋白尿被认为是心血管疾病的独立危险因素。因此,我们研究了2型糖尿病患者尿白蛋白/肌酐比值(UACR)与冠状动脉钙化评分(CCS)的关系。方法:选取2007年12月~ 2008年5月在庆北大学医院行多层CT扫描评价CCS的2型糖尿病患者155例。评估了CCS、人口统计和实验室数据。结果:90例(51%)患者发现冠状动脉钙化,平均、中位CCS为205.8±476.9,8.74(0,132.0)。60例UACR大于30 ug/mg。随着UACR的增加,CCS显著增加(P < 0.001)。年龄、糖尿病病程、血清载脂蛋白A1水平、血清高敏c反应蛋白(hs-CRP)水平也与CCS相关。然而,在调整年龄后,UACR与CCS呈显著正相关(P = 0.002)。结论:UACR升高与2型糖尿病患者冠状动脉钙化有关,这些结果将有助于早期评估这些患者是否存在大血管并发症。(韩国糖尿病杂志33:29 - 298,2009)
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