41 st The European Association for Study of Diabetes (EASD), Greece, Greece, 10 - 15 September 2005, pp.368
Conference Paper / Full Text
Background and Aims: Microalbuminuria is the first clinical sign of diabetic nephropathy.However, microalbuminuria is also a strong predictor of cardiovascular risk in both diabetic and non-diabetic individuals. Therefore microalbuminuria could be accepted as an indicator of widespread endothelial damage. Ischemia modified albumin (IMA) is a novel marker of tissue ischemia. It has shown to be increased in acute ischemic events. In this study we planned to assess the correlation of IMA and microalbuminuria in addition to other macrovascular risk factors in diabetic patients without overt macrovascular disease.
Materials and Methods: Fifty-two diabetic patients without a history of macrovascular disease or overt nephropathy were enrolled into the study. Age matched 30 healthy individuals were also included in the study as a control group. Both groups were evaluated with anthropometric measurements, metabolic parameters, C-reactive protein (CRP), and IMA. In addition
to those plasma homocystein and microalbuminuria levels were studied in diabetic subjects. Presence of neuropathy and retinopathy were evaluated by specific tests.
Results: Age, body mass index, and serum lipid levels were not different between the two groups. Plasma IMA (0,3446±0,03947 and 0,2652± 0,04504 AbsU, p<0,0001) and CRP levels (0,47±0,41 and 0,32±0,18 mg/dl; p=0,041) were significantly higher in the diabetic group compared with healthy controls. IMA levels were significantly correlated with CRP
(r=0,57;p=0,012) and plasma homocystein (r=0,46;p=0,004) levels in diabetic subjects. In the diabetic patients group presence of microalbuminuria was associated with a higher plasma IMA level (0,3598±0,03600 and 0,3261±0,0366 AbsU, p=0,011, patients with or without microalbuminuria, respectively).We did not find any specific association of plasma IMA levels with retinopathy or neuropathy.
Conclusion: Diabetic patients without an overt cardiovascular disease still have a higher serum IMA level in comparison with healthy controls. The correlation of high plasma IMA levels with high CRP and homocystein levels in diabetic subjects indicates the presence of a chronic ischemic process. Therefore diabetes should be regarded as a cardiovascular risk equivalent as indicated in the recent cardiovascular disease guidelines.