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IJE Advance Access published online on June 16, 2006
International Journal of Epidemiology, doi:10.1093/ije/dyl115
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Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2006; all rights reserved.
Accepted May 4, 2006

Original paper

Albuminuria as a marker of the risk of developing type 2 diabetes in non-diabetic Aboriginal Australians

Zhiqiang Wang 1 * and Wendy E. Hoy 1

1 Centre for Chronic Disease, Department of Medicine--Central Clinical Division, The University of Queensland, Brisbane, Queensland, Australia

* To whom correspondence should be addressed.
Zhiqiang Wang, E-mail: zwang{at}ccs.uq.edu.au


  Abstract

Background Aboriginal Australians experience a higher risk of diabetes than the general Australian population. In this paper, we conducted a nested case-control study to determine whether the presence of microalbuminuria and macroalbuminuria is associated with the development of diabetes among diabetes-free Aboriginal people at baseline.

Methods Urine albumin to creatinine ratios (ACRs) were obtained from 882 Aboriginal people aged 20-74 years from one community. Among them 750 were free of either clinical known diabetes or newly diagnosed diabetes according to WHO 1999 criteria. Over an 11 year follow-up period, 117 participants developed diabetes. They were defined as cases. Each case was matched by an individual control with same sex and body mass index (BMI) category, and age within 2 years. Conditional logistic regression was used to assess the association between albuminuria and diabetes.

Results The baseline level of ACR was significantly higher among cases than among controls. The odds ratios for future diabetes were 2.36 [95% confidence interval (95% CI) 1.01-5.50] and 3.27 (95% CI 1.38-7.77) for middle and upper tertiles, respectively, with adjustment for age, BMI, serum total cholesterol, serum C-reactive protein values, and fasting plasma glucose at the baseline. The adjusted odds ratios were 1.90 (95% CI 0.88-4.06) and 2.51 (95% CI 1.08-5.87) for those with microalbuminuria and macroalbuminuria, respectively.

Conclusions The presence of microalbuminuria and macroalbuminuria predicts diabetes independent of other known risk markers of development of type 2 diabetes in Aboriginal people.

Keywords: diabetes in minorities; albuminuria; case-control; aboriginal health; epidemiology.
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