Diabetes Research and Clinical Practice 39 (1998) 63 – 67
Cardio vascular morbidity in proteinuric South Indian NIDDM
patients
Vijay Viswanathan *, C. Snehalatha, Terin Mathai, Muthu Jayaraman,
A. Ramachandran
Diabetes Research Centre, No. 5, Main Road, Royapuram, Chennai, 600 013, India
Received 21 March 1997; received in revised form 8 July 1997; accepted 13 July 1997
Abstract
Proteinuria is a well known risk factor for cardiovascular morbidity. There has been no report on cardiovascular
morbidity in Indian NIDDM patients with proteinuria. Hence this study has been undertaken to estimate the
prevalence of cardiovascular diseases (CVD) in South Indian NIDDM with proteinuria. We studied two groups of
NIDDM patients with diabetes for 5 years: group PR with persistent proteinuria of 500 mg/day (n =297) and
group NPR with normoalbuminuria (albuminuria 30 g/mg creatinine) (n =296), who reported for review during
the study period. They were matched for age, duration of diabetes and BMI. The prevalence of cardiovascular
diseases, namely myocardial infarction, the presence of ischaemic heart disease and the history of coronary bypass
surgery were compared in the two groups. The prevalence of hypertension was higher among the PR than the NPR
patients (56.5 vs 24.7%,
2
=61.3, P 0.001). CVD were detected in 39.2% (n =116) of the PR and 13.2% (n =39)
of the NPR groups. (
2
=54.85, P 0.001). The risk was thus three-fold higher in the PR group. Univariate analysis
showed that in the proteinuric group, the prevalence of complications was higher in association with hypertension
(45.8 vs 30.2%,
2
=6.82, P =0.009). Multiple logistic regression analysis showed that the factors associated with
CVD were proteinuria (odds ratio 5.03), age (OR 1.08) and BMI (OR 1.07) while sex, age at onset of diabetes,
duration of diabetes, hypertension, smoking, HbA
1
, serum creatinine, cholesterol and triglycerides did not show
independent contribution. The study, highlights the high risk conferred by macroproteinuria in Indian NIDDM
patients. This risk is found to be independent of the presence of associated hypertension. © 1998 Elsevier Science
Ireland Ltd. All rights reserved.
Keywords: Cardiovascular morbidity; Proteinuria; NIDDM; Hypertension
* Corresponding author. Tel.: +91 44 5954913/5954916; fax: +91 44 5954919; e-mail: diabetes.research@gems.vsnl.net.in
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