Microalbuminuria, Cardiovascular Morbidity, and Mortality in Diabetic and Non–Diabetic Subjects in Kirkuk City

Abstract

Ischemic heart disease (IHD) which, leading cause of death in industrialized nations. Traditional risk factors for (IHD) such as hypertension, smoking, diabetes, and hyperlipidemia may not be able to predict cardiovascular events accurately in male and female. Early detection and prevention of (IHD), especially among the elderly, remains a major public health issue. The aim of this study was estimate the frequency of microalbuminuria in patients with and without diabetes mellitus (DM), answering the question: 'How relevant for general practice are epidemiological findings that microalbuminuria is a significant risk indicator for the development of cardiovascular syndromes?' and analyze prospectively whether the urinary albumin to creatinine (A/C) ratio can indepenendently predicts ischemia heart disease (IHD) in a population suffering from diabetes mellitus (DM) in Kirkuk city. The study group conducted on (120) patients with (IHD) and (DM) their age ranging between (20-79) years and (100) aged matched health control subjects .The males consisted (52.27%) of the total patients, while females (47.73%). They characterized by sex, age, body mass index (BMI), blood pressure (Bp), fasting blood glucose (FBG), serum albumin and creatinine.An interaction between microalbuminuria and IHD with DM was observed, and presence of microalbuminuria more than doubled predictive effect of the conventional atherosclerotic risk factor for development of IHD. Urinary albumin/creatinine ratio is recommended for microalbuminuria assessment, because it reflects urinary albumin excretion. Muscular mass could affect albumin/creatinine ratio, because urinary creatinine reflects muscular mass. Prevalence showed significant higher in the normal male than female individuals and this attributed to the difference in the lean muscle mass between the two sex and more fragrantly in (BMI) of (24-26) Kg/m2 in male groups than females. The relationship of obesity on microalbuminuria and (IHD) was statistically significant the (P) values was found to be (<0.05) in the both sexes.The prevalence of the patient groups suffering from previous signs of ( IHD) with type (I) diabetes mellitus in the nonhigh (uACR) groups were (23.3%), high (uACR) without microalbuminuria groups were (30%) and high (uACR) with microalbuminuria groups were (46.7%) while in the groups with patient suffering from previous signs of ( IHD) with type (II) diabetes mellitus were (20%),(32.2%) and (47.7%) respectively. The excess of the patient groups suffering from previous signs of (IHD) with type (II) diabetes mellitus prevalence in the high (uACR) groups reflected the combination of dissimilar data between the subgroups with and without microalbuminuria .In comparison to the nonhigh (uACR), the patient groups suffering from previous signs of (IHD) with type (II) diabetes mellitus prevalence was significantly increased (P<0.05) in the high (uACR) subgroup with microalbuminuria but not in the high (uACR) subgroup without microalbuminuria