Low transition rate from normo- and low microalbuminuria to XXXX in Japanese type 2 diabetic individuals: the Japan Diabetes Complications Study (JDCS).

@entity1 @entity644 @entity8 @entity101 @entity6 @entity2316 @entity1011
AIMS/HYPOTHESIS: The aim of the study was to determine the transition rate and factors associated with the progression of normo- and low microalbuminuria to @entity2316 (overt @entity644 ). METHODS: For 8 years we prospectively observed 1,558 Japanese @entity1 with @entity6 whose basal urinary albumin: @entity1011 ratio (UACR) had been measured as <17.0 mg/mmol at entry. The incidence of @entity8 (UACR >33.9 mg/mmol) was determined by measuring UACR twice a year. RESULTS: Progression to @entity8 occurred in 74 @entity1 . The annual transition rate was 0.67%, and was substantially higher for the low-microalbuminuric group than for the normoalbuminuric group (1.85% and 0.23%, respectively; hazard ratio for the low-microalbuminuric group 8.45, p   <   0.01). The hazard ratio for an HbA(1c) of 7-9% or >= 9% was 2.72 (p   <   0.01) or 5.81 (p   <   0.01) relative to HbA(1c) <7.0%, respectively. In comparison with individuals with a systolic blood pressure (SBP) of <120 mmHg, the hazard ratios for @entity1 with an SBP of 120-140 mmHg or >= 140 mmHg were 2.31 (p   =   0.06) and 3.54 (p   <   0.01), respectively. Smoking also affected progression to @entity644 (hazard ratio 1.99, p   <   0.01). In contrast, 30.3% of the low-microalbuminuric group returned to normoalbuminuria (i.e. were in remission). CONCLUSIONS/INTERPRETATION: These results suggest that if @entity1 with @entity6 are receiving treatment from diabetologists for hyperglycaemia and @entity101 when they are in the early stages of @entity8 (i.e. normo- or low microalbuminuria), their rate of transition to @entity644 is considerably lowered, and that differentiating @entity1 with low microalbuminuria from those with high microalbuminuria might be clinically useful. TRIAL REGISTRATION: UMIN Clinical Trials Registry C000000222.
