Endocrine Abstracts

Objective: The association between albuminuria and peripheral artery disease (PAD) could be confounded by renal function. Albuminuria reflects generalized disruption of endothelial cell function. This study was conducted to examine the association of PAD with low glomerular filtration rate (GFR) and albuminuria in diabetic patients.

Methods: A total of 254 diabetic patients were included. We examined the age, sex, duration of diabetes, GFR, urinary albumin, high-sensitivity C–reactive protein (hsCRP), and presence of hypertension, dyslipidemia, coronary artery disease, stroke, and PAD. Patients with estimated GFR <60 ml/min per 1.73 m² were classified as having chronic kidney disease (CKD). Urinary albumin was measured using urine albumin:creatinine ratio (ACR) and albuminuria was defined as microalbuminuria (ACR, ≥30 and <300 mg/g) and proteinuria (ACR, ≥300 mg/g).

Results: When stratified by the presence of CKD, there were statistical differences in age (normal vs CKD, 60.48 vs 65.16 years), sex (female, 37.6 vs 52.6%), duration of diabetes (8.44 vs 14.78 years), urinary albumin (no albuminuria/microalbuminuria/proteinuria, 37.4/42.7/19.9 vs 15.8/36.0/48.0%), and presence of hypertension (59.6 vs 84.2%), dyslipidemia (60.1 vs 75.0%), and stroke (15.7 vs 32.9%). There was no difference of PAD in patients with and without CKD. When stratified by the urinary albumin, there were statistical differences in presence of hypertension (no albuminuria/microalbuminuria/proteinuria, 52.6/65.0/88.6%), CKD (15.8/27.0/51.4%), and PAD (7.9/19.0/27.1%). When stratified by the presence of PAD, there were statistical differences in age, sex, duration of diabetes, urinary albumin, hsCRP, and presence of hypertension and CAD. There were no statistical differences in the CKD and presence of stroke in patients with and without PAD.

Conclusion: These results suggest that PAD in diabetic patient is more associated with albuminuria than renal function, and hsCRP might be used in diagnosis or screening of PAD in diabetic patients.