Microalbuminuria and its Association with Subclinical Atherosclerosis in the Mexican Mestizo population: the GEA study

Aida X. Medina-Urrutia, Department of Endocrinology, Instituto Nacional de Cardiología Ignacio Chávez (INCICh), Mexico City, Mexico; Postgraduate Program in Biological Sciences, Postgraduate Unit, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
Juan G. Juárez-Rojas, Department of Pharmacology, INCICh, Mexico City, Mexico
Rosalinda Posadas-Sánchez, Endocrinology Department, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
Esteban Jorge-Galarza, Endocrinology Department, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
Guillermo C. Cardoso-Saldaña, Endocrinology Department, Instituto Nacional de Cardiología Ignacio Chávez, SSA, Mexico City, Mexico
Gilberto Vargas-Alarcón, Molecular Biology Department, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
Rocío Martínez-Alvarado, Endocrinology Department, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico
Carlos Posadas-Romero, Endocrinology Department, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico

Background: Microalbuminuria is an early marker of atherosclerosis. Ethnic differences for both conditions have been reported. We studied microalbuminuria prevalence and its association with coronary artery calcification as an early atherosclerosis marker in a Mexican-Mestizo population free of diabetes and hypertension (healthy), as well as in hypertensive and diabetic subjects. Methods: In 1,472 adults (53.3 ± 9.4 years old, 50.3% women), anthropometric measurements, fasting blood glucose, and lipid profile were determined. A spot urine sample was used to quantify the albumin-to-creatinine ratio and to define microalbuminuria (20-200 mg/g in men, and 30-300 mg/g in women). A coronary artery calcification score was obtained by electron-beam computed tomography and subclinical atherosclerosis was defined as a score > 0. Results: Overall microalbuminuria prevalence was 9.3% (5.4% in healthy, 11.6% in obese, 12% in hypertensive, and 25% in diabetic subjects). Compared to “healthy” subjects without microalbuminuria, those with microalbuminuria had a ∼3-fold higher prevalence of coronary artery calcification > 0, while normal-high albumin-to-creatinine ratio (OR: 1.8; p < 0.05) and microalbuminuria (OR: 2.6; p < 0.001) was independently associated with coronary artery calcification > 0 only among diabetic subjects. Conclusions: Microalbuminuria and high-normal albumin-to-creatinine ratio were independently associated with subclinical atherosclerosis, suggesting that they may confer a higher risk of future cardiovascular events.

Keywords: Coronary artery calcium. Microalbuminuria. Subclinical atherosclerosis.