International Journal of Clinical Biochemistry and Research

Print ISSN: 2394-6369

Online ISSN: 2394-6377

CODEN : IJCBK6

International Journal of Clinical Biochemistry and Research (IJCBR) open access, peer-reviewed quarterly journal publishing since 2014 and is published under auspices of the Innovative Education and Scientific Research Foundation (IESRF), aim to uplift researchers, scholars, academicians, and professionals in all academic and scientific disciplines. IESRF is dedicated to the transfer of technology and research by publishing scientific journals, research content, providing professional’s more...


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Ahsan, Qureshi, Samreen, and Kukreti: Study of HbA1c & microalbumin in urine in patients of metabolic syndrome


Introduction

The term metabolic Syndrome refers to: abdominal obesity, insulin resistance, hypertension & dyslipidemia (elevated triglyceride and decreased HDL Cholesterol level).1

Microalbuminuria, defined as a urine albumin- creatinine ratio (UACR) of > 2 g/mmol, originally has been used as an early warning sign of chronic kidney disease and diabetic nephropathy by H.C. Gerstein & J.F. Mann.2 Additionally, it has been known as a useful predictor of cardiovascular events in adults.3, 4, 5 Microalbuminuria is considered as an early indicator of chronic renal disorder, vascular dysfunction and cardiovascular mortality.6, 7, 8 Microalbuminuria is more frequent in subjects with type 2 Diabetes8 and has been included in the unifying definition of Metabolic Syndrome (MetS) suggested by WHO.9 In previous studies, microalbuminuria was associated with hypertension and abdominal obesity.10, 11

MetS is a group of metabolic abnormalities characterized by elevated blood pressure, hyperglycemia, abdominal obesity, high triglycerides and reduced high-density lipoprotein cholesterol that collectively increases the risk of diabetes, cardiovascular diseases, and overall mortality.12, 13, 14 The American Heart Association criteria15 did not include microalbuminuria as part of MetS. Several studies have shown association of microalbuminuria with MetS and its components in adults.16, 17, 18

Table 1

Male

Female

Parameter

Mean±SD

Mean±SD

T Value

P Value

Significant

Age

55.84±13.52

57.56±10.08

0.7212

0.4725

NS(P≥0.05)

HBA1C

8.564±2.663

11.62±12.86

2.327

0.021

S(P≤0.05)

Table 2

Male

Female

Parameter

Mean±SD

Mean±SD

T Value

P Value

Significant

Age

55.84±13.52

57.56±10.08

0.7212

0.4725

NS(P≥0.05)

Microalbumin

371.5±1184

60.37±116.6

2.7832

0.0059

S(P≤0.05)

Table 3

Raised

Unraised

Parameter

Mean±SD

Mean±SD

T Value

P Value

Significant

HBA1C

10.42±9.628

5.066±0.216

5.5595

0.0001

S(P≤0.05)

Microalbumin

412.1±1133

11.97±7.129

3.5315

0.0005

S(P≤0.05)

Table 4

Male

Female

Parameter

Mean±SD

Mean±SD

T Value

P Value

Significant

HBA1C

8.564±2.663

11.62±12.86

2.327

0.021

S(P≤0.05)

Microalbumin

391.5±1184

60.37±116.6

2.7832

0.0059

S(P≤0.05)

Table 5

HBA1C

Microalbumin

Parameter

Mean±SD

Mean±SD

T Value

P Value

Significant

Age

56.7±11.89

56.7±11.89

0

1

NS(P≥0.05)

observed value

12.24±12.88

280.5±1043

2.5718

0.0108

S(P≤0.05)

HbA1c refers to glycated haemoglobin. It develops when haemoglobin, a protein within red blood cells that carries oxygen throughout your body, joins with glucose in the blood becoming glycated. By measuring glycated haemoglobin clinicians are able to get an overall picture of what our average blood sugar levels have been over period of weeks/months. When the body processes sugar, glucose in the blood stream naturally attaches to haemoglobin. The amount of glucose that combines with this protein is directly proportional to the total amount of sugar that is in our system at that time. Because red blood cells in human body is for 8-12 weeks before renewal measuring glycated haemoglobin can reflect average blood glucose levels over that duration providing a useful longer term blood glucose control.

Results

According to this study there is significant correlation of HbA1c and Microalbumin in patients of Metabolic syndrome. When we compared both HbA1c and microalbumin in both males and females then mean and SD came out for HbA1C for males 8.56±2.663 and females were 11.62±12.86 with t value 2.327 and p value 0.021 that states it was significant. And for micoralbumin for male 391.5±1184 & for females 60.37±116.6 t value was 2.7832 and p value was 0.0059 it also states it was significant.

Therefore both the parameters were significant in patients of metabolic syndrome.

Discussion

In this study we found strong positive associations between microalbuminuria and metabolic syndrome in both males and females. These results indicate microalbuminuria may be a component of metabolic syndrome supporting results from other epidemiological studies.19, 20, 21, 22 Hypertension has long been associated with microalbuminuria.19, 20, 23, 24 Increased intraglomerular capillary pressure is thought to cause leakage of albumim.25 Clinically microalbuminuria may be an indicator of early vascular complications of hypertension. Yudkin26 proposed in 1996 that the clustering of risk factors attributed to insulin resistance and microalbuminuria may all be features of damage to different aspects of endothelial functions. Signs of early endothelial dysfunction as manifested by microalbuminuria may herald impending renal impairment and may offer another focus for treatment of metabolic syndrome.

Studies suggest that prevalence of microalbuminuria is greatest in populations with both hypertension and diabetes.27, 28, 29 Microalbuminuria may reflect chronicity of even mild BP and glucose elevations.

Further research in this area could investigate the longitudinal relationship and explre pathways between metabolic syndrome and microalbuminuria.

Source of Funding

None.

Conflict of Interest

The authors declare no conflict of interest.

References

1 

GM Reaven Role of insulin resistance in human disease (Syndrome X): an expanded definitionAnnu Rev Med19934412131

2 

HC Gerstein JF Mann J Pogue SF Dinneen JP Hallé B Hoogwerf Prevelance and deteminats of microalbuminuria in high risk diabetic and non diabetic patients in the heart outcomes prevention evaluation studyDiabetes Care2000232B35B9

3 

ME Widlansky N Gokce JF Keaney JA Vita The clinical implications of endothelial dysfunctionJ Am Coll Cardiol2003427114960

4 

JJ Cao JI Barzilay D Peterson the association of microalbuminuria with clinical cardiovascular disease and subclinical atherosclerosis in the elderly: the cardiovascular health studyAtherosclerosis200618723727

5 

D Dutta S Choudhuri S A Mondal S Mukherjee S Chowdhury Urinary albumin: creatinine ratio predicts prediabtes progression to diabetes and reversal to normoglycemia: role of associated insulin resistance ,inflammatory cytokines and low vitamin DJournal of Diabtes201464316322

6 

HC Gerstein JF Mann Q Yi B Zinman SF Dinneen B Hoogwerf Albuminuria and risk of cardiovascular events, death, and heart failure in diabetic and non diabetic individualsJAMA20012864216

7 

HJL Heerspink JW Brinkman SJL Bakker RT Gansevoort D Zeeuw Update on microalbuminuria as a biomarker in renal and cardiovascular diseaseCurr Opin Nephrol Hypertens20061566316

8 

P Ochodnicky RH Henning RPE Van Dokkum D De Zeeuw Microalbuminuria and endothelial dysfunction: emerging targets for primary prevention of end- organ damageJ Cradiovasc Pharmacol200647215162

9 

KG Alberti PZ Zimmet Definition, diagnosis and classification of diabtes mellitus and its complications. Part 1:diagnosis and classification of diabetes mellitus provisional report of a Who consultationDiabet Med199815753953

10 

S Bianchi R Bigazzi VM Campese Microalbuminuria in essential hypertension: significance, pathophysiology, and therapeutic implicationsAm J Kidney Dis199934697395

11 

R Scaglione A Ganguzza S Carrao G Perrinrllo MA Dichiara Central obesity and hypertension: pathophysiologic role of enal haemodynamics and functionInt J Obes Metab Disord J Int Assoc Study Obes1995194039

12 

SM Grundy Metabolic syndrome: z multiplex cardiovascular risk factorJ Clin Endocrinol Metab200792399404

13 

B Isomaa P Almgren T Tuomi B Forsen K Lahti M Nissen Cardiovascular morbidity and mortality associated with the metabolic syndromeDiabetes Care20012446839

14 

DE Laaksonen HM Lakka LK Niskanen GA Kaplan JT Salonen TA Lkka Metabolic Syndrome and development of diabtes mellitus: applications and validation of recently suggested definitions of the metabolic syndrome in a prospective cohort studyAm J Epidemiol20021561110707

15 

SM Grundy JI Cleeman SR Daniels KA Donato RH Eckel BA Franklin Diagnosis and management of the metabolic syndrome :an American Herat Association? National Heart, Lung and blood institute scientific statementCirculation2005112273552

16 

B Chen D Ynag Y Chen W Xu B Ye ZY Ni The prevelance of microalbuminuria and its relationships with the components of metabolic syndrome in the general population of ChinaClin Chim Acta20104119-107059

17 

Z Hao T Konta S Takasaki H Abiko M Ishikawa T Takahashi The association between microalbuminuria and components of metabolic syndrome in general population in Japan: the Takahata studyIntern Med Tokyo Jpn20074673416

18 

Q Li W Jia J Lu L Chen Y Wu S Jiang Relationship between the prevalence of microalbuminuria and components of metabolic syndrome in ShangaiZhonghua Liu Xing Bing Xue Za Zhi2004251658

19 

L Mykkanen DJ Zaccaro LE Wagenknecht DC Robbins M Gabriel SM Haffner Microalbuminuria is associated with insulin resistance in nondiabetic subjects:the insulin resistance atherosclerosis studyDiabetes1998475793800

20 

AD Liese HW Hense A Doring J Stieber U Keil Microalbuminuria, central adiposity and hypertension in the non diabetic urban population of the MONICA Augsburg survey 1994/95J Hum Hypertens200115799804

21 

CM Hoehner KJ Greenlund S Rith-Najarian ML Casper WM McClellan Association of the insulin resistance syndrome and microalbuminuria among nondiabetic Native Americans. The Inter-Tribal Heart ProjectJ Am Soc Nephrol2002136162634

22 

B Isomaa P Almgren T Tuomi B Forsen K Lahti M Nissen Cardiovascular morbidity and mortality associated with the metabolic syndromeDiabetes Care20012446839

23 

SR Srinivasan L Myers GS Berenson Risk variables of insulin resistance syndrome in African-American and Caucasian young adults with microalbuminuria : the Bogalusa Heart StudyAm J Hypertens2000131212749

24 

X Jiang SR Srinivasan B Radhakrishnamurthy ER Dalferes W Bao GS Berenson , Microalbuminuria in young adults related to blood pressure in a biracial population. The Bogalsua Heart StudyAm J Hypertens199479 Pt 1794800

25 

BM Brenner Hemodynamically mediated glomerular injury and the progressive nature of kidney diseaseKidney Int198323464755

26 

JS Yudkin Hyperinsulinaemia, insulin resistance, microalbuminuria and the risk of coronary heart diseaseAnn Med19962854338

27 

HC Gerstein JF Mann J Pogue SF Dinneen JP Halle B Hoogwerf Prevelance and determinants of microalbuminuria in high risk diabetic and non diabetic patients in the heart Outcomes Prevention Evaluation Study. The HOPE Study InvestigatorsDiabtetes Care200023Suppl 2B359

28 

RD Lindeman L Romero HC Liang R Hundley R Baumgartner K Koehler Prevelance of proteinuria/microalbuminuria in an elderly urban,biethnic communityGeriatr Nephrol Urol19988312330

29 

E Wrone M Carnethon L Palaniappan S Fortmann Association of dietary protein intake and microalbuminuria in healthy adults:Third National Health and Nutrition ExaminationAm J Kidney Dis200341580587



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Article type

Original Article


Article page

308-311


Authors Details

Farah Ahsan*, Naeem Qureshi, Sumera Samreen, Sonali Kukreti


Article History

Received : 27-10-2021

Accepted : 27-11-2021

Available online : 05-01-2022


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