Predictors of progression from normoalbuminuria to microalbuminuria in XXXX .

@entity2175 @entity1 @entity8 @entity1095 @entity4051 @entity6 @entity301 @entity16 @entity2412 @entity989 @entity413
OBJECTIVE: Our objective was to establish the clinical, genetic, metabolic, and immunologic risk factors for the progression of the albumin excretion rate (AER) in normoalbuminuric @entity2175 @entity1 . RESEARCH DESIGN AND METHODS: We recruited 108 @entity2175 @entity1 with normal AER after a @entity6 duration of 9 years to participate in a prospective 9-year follow-up. In addition to conventional clinical and metabolic variables, we assessed microvascular ( @entity989 , @entity8 , @entity16 ) and macrovascular ( @entity301 , @entity1095 ) @entity2412 , genetic markers (HLA genotypes), and organ-specific autoimmune markers, including islet cell antibodies. Multiple logistic regression was used to determine independent predictors of progression of AER. RESULTS: A total of 21 @entity1 (19%) died during the follow-up. There was an overrepresentation of @entity1 (61 vs. 39%; P = 0.044) and smokers (55 vs. 27%; P = 0.01) in @entity1 who progressed to micro- or macroalbuminuria versus those who did not progress. In addition, progressors had higher fasting plasma @entity413 (P = 0.002) and @entity4051 (P = 0.0002) concentrations at baseline than did nonprogressors. @entity16 was more often seen in progressors than in nonprogressors at baseline (53 vs. 16%; P = 0.0004). Frequency of HLA genotypes and autoimmune markers did not differ between progressors and nonprogressors. In a multiple logistic regression analysis, @entity4051 (P = 0.0005) and a history of smoking (P = 0.011) were independent predictors of progression of AER. CONCLUSIONS: This study reemphasizes the importance of poor glycemic control and smoking as independent risk factors for progression of AER. Furthermore, development of micro- or macroalbuminuria in @entity2175 was associated with @entity16 and male sex.
