Abstract:
BACKGROUND AND OBJECTIVES: Few data are available on the extent of albuminuria in diabetic populations in the Middle East generally and in Lebanon specifically. We conducted this study to determine the prevalence of albuminuria and its major risk factors in a cohort of diabetic patients in Lebanon. PATIENTS AND METHODS: Diabetic patients followed in the outpatient department at the American University of Beirut Medical Center (AUBMC) were included in a prospective observational study. AUBMC is a tertiary referral center and the outpatient department typically handles patients of low socioeconomic status with advvanced disease. Patients were classified according to their urinary albumin-to-creatinine ratio (ACR) as having normoalbuminuria (ACR30 mg-g creatinine), microalbuminuria (ACR=30 to 300 mg-g creatinine), or macroaalbuminuria (ACR =300 mg-g creatinine). The three groups were compared to analyze the association between albuminuria and its risk factors. In addition, independent predictors of albuminuria were determined using multivariate logistic regression and presented as an odds ratio. RESULTS: Microalbuminuria and macroalbuminuria were present in 33.3percent and 12.7percent of 222 patients (mean age 56.4 years, mean deviation of diabetes 8.6 years, 58.7percent women, 43.8percent obese), respectively. Factors significcantly associated with microalbuminuria included glycemic control, insulin use, and total and LDL cholesterol. Those associated with macroalbuminuria included in addition to glycemic control and insulin use, duration of diabetes, hypertension, elevated mean arterial pressure (MAP), and presence of neuropathy, retinopathy and peripheral vascular disease by bivariate analysis. Only glycemic control was an independent risk factor for both in addition to MAP and retinopathy for macroalbuminuria by multivariate analysis. CONCLUSION: Albuminuria is highly prevalent among this cohort of diabetic patients in Lebanon. Both glycemmic control and blood pressure need to be better targeted in its management. © Annals of Saudi Medicine.