Association Between Urine Albumin Excretion And Cardiovascular Risk Factors In Newly Diagnosed Type 2 Diabetic Patients

Abstract

Background:
Type 2 Diabetes Mellitus (T2DM) is a progressive metabolic disorder associated with significant microvascular and macrovascular complications. Microalbuminuria, defined as urinary albumin excretion between 30–300 mg/day, is a key early indicator of diabetic nephropathy and an independent predictor of cardiovascular disease (CVD). Identifying urinary markers in conjunction with traditional cardiovascular risk factors can provide critical insight into early diabetic complications.
Materials and Methods:
A cross-sectional observational study was conducted at the Department of Biochemistry, Malwanchal University, Indore, involving 636 subjects—318 with newly diagnosed T2DM and 318 age- and sex-matched controls. Spot urine samples were used to measure the albumin-creatinine ratio (ACR) and protein-creatinine ratio (PCR). Serum creatinine levels, fasting blood glucose, glycated hemoglobin (HbA1c), blood pressure, and lipid profiles (total cholesterol, LDL, HDL) were recorded. Statistical analyses were performed to compare renal and cardiovascular parameters between groups.
Results:
Significantly elevated ACR (38.6 ± 12.4 mg/g) and PCR (0.42 ± 0.13 mg/g) were observed in T2DM cases compared to controls (12.3 ± 4.5 mg/g and 0.18 ± 0.09 mg/g, respectively; p < 0.001). Serum creatinine was also higher among diabetics (1.12 ± 0.16 mg/dL vs. 0.89 ± 0.12 mg/dL; p < 0.001). Cardiovascular risk parameters—systolic BP (138 ± 10 mmHg), HbA1c (7.9 ± 0.8%), and fasting glucose (155 ± 18 mg/dL)—were markedly higher in cases. Lipid analysis revealed increased total cholesterol and LDL, with decreased HDL levels, all statistically significant (p < 0.05).
Conclusion:
Urinary ACR and PCR are reliable early indicators of subclinical renal damage and are significantly associated with elevated cardiovascular risk parameters in newly diagnosed T2DM patients. Incorporating these non-invasive urine markers into routine screening can enhance early identification and targeted management of both renal and cardiovascular complications in diabetes.