Cardiovascular risk factors are differently associated with urinary albumin excretion in men and women
ABSTRACT Cardiovascular morbidity and mortality is not equally distributed among genders, men being more affected than women. It is not clear whether this is only related to a higher prevalence of the cardiovascular risk factors or to a similar prevalence of the risk factors as in women but a greater vascular susceptibility to these risk factors in men. This was tested by studying the association between various cardiovascular risk factors and urinary albumin excretion (UAE) in a large cohort of male and female subjects. While the prevalence of smoking and hypercholesterolemia was comparable between the genders, obesity was more common in women, and diabetes and hypertension were more frequent in men. The prevalence of microalbuminuria was about twofold higher in men. Interestingly, for a given level of any risk factor, UAE was higher in men than in women. On multivariate analysis with UAE as the dependent variable, an interaction with gender was found for the risk factors age, body mass index, and plasma glucose. Thus, for a higher age, body mass index, and glucose, the UAE is significantly increased in men when compared with women. It is concluded that gender differences exist in the association between cardiovascular risk factors and UAE. This is consistent with a larger vascular susceptibility to these risk factors in men as compared with women.
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ABSTRACT: Insulin resistance i s considered as a fundamental component of the pathogenesis of type 2 diabetes. People have suggested the possibility that treating and modifying insulin resistance in patients of type 2 diabetes would improve urine albumin excretion. This study was planned with an objective to investigate the relationship of insulin resistance with microalbuminuria in patients of type 2 diabetes mellitus and observe any difference between men and women in this association, in Pakistani population. This study was carried out and Diabetes clinic of Combined Military Hospital, Malir Cantt, from April 2007 to August 2007. One hundred and fifty five patients of type 2 diabetes mellitus were included in the study that had either microalbuminuria or normoalbuminuria. Body mass index, waist circumference and blood pressure were recorded. Fasting venous blood sample was collected for plasma glucose (FPG), serum insulin, total and HDL cholesterol, triglycerides, creatinine and HbA1c. Urine albumin excretion was determined using urine albumin to creatinine ratio. Insulin resistance was calculated from fasting plasma glucose and serum insulin levels, using homeostatic model assessment of insulin resistance (HOMA-IR). Microalbuminuria was found to be significantly correlated with HOMA-IR (r = 0.33, p = < 0.0001), serum insulin (r = 0.28, p = < 0.001), body mass index (r = 0.18, p = 0.02) and waist circumference (r = 0.21, p = 0.008). This correlation was more significant in women (n = 85, r = 0.48, p = < 0.0001) as compared to men (n = 70, r = 0.14, p = 0.12). The correlation between HOMA-IR and urine albumin excretion remained highly significant (p = 0.001) after controlling for gender, age, duration of diabetes, waist circumference, hypertension, triglycerides and HbA1c. 6 HOMA-IR was also significantly correlated with waistcircumference (r = 0.24, p = 0.001), BMI (r = 0.16, p = 0.02), triglycerides (r = 0.22, p = 0.003), HDL cholesterol (r = 0.18, p = 0.01), HbA1c (r = 0.35, p = < 0.0001), FPG (r = 0.44, p = < 0.0001) and metabolic syndrome (r = 0.18, p = 0.01) The study concludes that urine albumin excretion in patients of type 2 diabetes is strongly associated with insulin resistance and related cardiovascular risk factors. This association appears to be stronger in women than men, in our population.
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ABSTRACT: The kidneys are responsible for regulating the body’s fluid volume, mineral composition and acidity. In order to do so, the kidneys depend on an adequate cardiac output. When the cardiac output is reduced, the interplay between kidneys and endocrine tissue will provoke activation of the renin angiotensin system. This neurohormonal cascade forms a strong link between the heart and kidneys. ... Zie: Summary
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ABSTRACT: L’obésité augmente la prévalence des maladies rénales chroniques. De nombreuses données épidémiologiques montrent que l’augmentation de l’indice de masse corporelle est principalement associée à l’apparition de glomérulopathies (GAO: glomérulopathies associées à l’obésité). Les GAO peuvent résulter soit de l’action délétère directe de facteurs sécrétés par le tissu adipeux comme la leptine, soit des mécanismes indirects liés aux pathologies associées à l’obésité (hypertension, diabète de type 2 ou dyslipidémies). Parallèlement aux stratégies thérapeutiques consistant à traiter séparément les néphropathies et l’obésité, des stratégies innovantes se développent (statines ou des agonistes des PPARs) ciblant plus spécifiquement les GAO. Obesity increases the prevalence of chronic kidney disease. Epidemiological data shows that higher body mass index is associated with glomerulonephritis, or obesity-related glomerulopathy (ORG). ORG can be induced directly by adipokines secreted by adipose tissue (leptin) or indirectly by obesity-related diseases (arterial hypertension, type 2 diabetes and dyslipidemia). Currently, nephropathy and obesity are treated separately. But, in the near future, the innovative use of statins and PPAR agonists could target ORG more specifically.Obésité 09/2007; 2(3):265-271. DOI:10.1007/s11690-007-0072-6