In individuals with type 2 diabetes, according to a study, measurable urinary protein excretion even in the normal range increases the risk of experiencing heart problems.
The findings could help identify patients who should be treated with cardioprotective medications, researchers wrote in the Journal of the American Society of Nephrology.
Some patients with type 2 diabetes experience albuminuria, or kidney problems that cause an excretion of increased amounts of the protein albumin in the urine. These patients have a considerably higher risk of developing heart problems than other diabetic patients and people in the general population with urinary albumin excretion levels of less than 20 micrograms per minute.
Investigators have wondered if any level of albumin excretion might increase a diabetic patient’s risk of developing heart problems. "It would be important to know whether there is a level for albuminuria that differentiates individuals in need of cardioprotective intervention from those with a low risk," study author Giuseppe Remuzzi, MD, FRCP, of the Mario Negri Institute for Pharmacological Research in Italy, said in a news release. "This is a major health issue since patients with normoalbuminuria account for at least 90% of the diabetic population."
The researchers evaluated the relationship between albumin excretion levels and heart problems in 1,208 normoalbuminuric patients with type 2 diabetes who were followed for an average of 9.2 years.
The researchers found that any degree of measurable albumin excretion bore significant heart risks. For each microgram per minute of albumin excretion at the start of the study, there was a progressive incremental risk of experiencing heart problems during follow-up. Even albuminuria of one to two micrograms per minute was significantly associated with increased risk compared with albuminuria of less than a microgram per minute.
When the investigators looked only at a subgroup of patients who took ACE inhibitors from the start of the study and throughout the follow-up period, they found no link between albumin excretion levels and heart risks.
This finding suggests that ACE inhibitors have heart-protective properties that may benefit diabetic patients with albuminuria and normoalbuminuria alike, the researchers said. Future clinical trials are needed to identify levels of albumin excretion above which such cardioprotective therapy is beneficial.
The study abstract is available at http://jasn.asnjournals.org/content/early/2012/08/29/ASN.2012030252.abstract.
The findings could help identify patients who should be treated with cardioprotective medications, researchers wrote in the Journal of the American Society of Nephrology.
Some patients with type 2 diabetes experience albuminuria, or kidney problems that cause an excretion of increased amounts of the protein albumin in the urine. These patients have a considerably higher risk of developing heart problems than other diabetic patients and people in the general population with urinary albumin excretion levels of less than 20 micrograms per minute.
Investigators have wondered if any level of albumin excretion might increase a diabetic patient’s risk of developing heart problems. "It would be important to know whether there is a level for albuminuria that differentiates individuals in need of cardioprotective intervention from those with a low risk," study author Giuseppe Remuzzi, MD, FRCP, of the Mario Negri Institute for Pharmacological Research in Italy, said in a news release. "This is a major health issue since patients with normoalbuminuria account for at least 90% of the diabetic population."
The researchers evaluated the relationship between albumin excretion levels and heart problems in 1,208 normoalbuminuric patients with type 2 diabetes who were followed for an average of 9.2 years.
The researchers found that any degree of measurable albumin excretion bore significant heart risks. For each microgram per minute of albumin excretion at the start of the study, there was a progressive incremental risk of experiencing heart problems during follow-up. Even albuminuria of one to two micrograms per minute was significantly associated with increased risk compared with albuminuria of less than a microgram per minute.
When the investigators looked only at a subgroup of patients who took ACE inhibitors from the start of the study and throughout the follow-up period, they found no link between albumin excretion levels and heart risks.
This finding suggests that ACE inhibitors have heart-protective properties that may benefit diabetic patients with albuminuria and normoalbuminuria alike, the researchers said. Future clinical trials are needed to identify levels of albumin excretion above which such cardioprotective therapy is beneficial.
The study abstract is available at http://jasn.asnjournals.org/content/early/2012/08/29/ASN.2012030252.abstract.
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