Metabolic syndrome increases the risk for microalbuminuria more than three-fold in Middle-Eastern people with Type 2 diabetes, an Iranian study shows.

A number of reports have demonstrated an association between the metabolic syndrome and microalbuminuria, but this relationship has been less well studied in people with Type 2 diabetes.

Alireza Esteghamati and co-workers (Tehran University of Medical Sciences, Tehran, Iran) recruited 800 consecutive adults with Type 2 diabetes attending for follow-up visits at an endocrinology clinic in Tehran.

Metabolic syndrome was defined by the International Diabetes Federation (IDF) criteria, with the exception of waist circumference, which was defined by recently established cut-offs for Middle-Eastern populations of 91.5 cm for men and 85.5 cm for women (compared with IDF values of 94 cm for men and 80 cm for women).

Microalbuminuria was defined by urinary albumin excretion between 30 and 299 mg/day on at least two of three occasions. Patients with macroalbuminuria and those with poor renal function were not included.

In this study, 645 patients had metabolic syndrome and 155 did not. Microalbuminuria was present in 237 (29.6%) patients with metabolic syndrome, and increased in prevalence with increasing numbers of metabolic abnormalities, report the authors in the journal Acta Diabetologica.

When patients were divided into those with (237 patients) and without (563 patients) microalbuminuria, metabolic syndrome was significantly more common among patients with microalbuminuria (90.3%) than those without (76.6%) even though there was no significant difference between the groups in terms of age, gender, and renal function.

Multivariate regression analysis revealed metabolic syndrome was the strongest correlate of microalbuminuria with an odds ratio of 3.3. This was followed by HbA1c and diabetes duration, which were both associated with a 1.3-fold greater risk for microalbuminuria.

The authors acknowledge that, as a cross-over study, the results do not allow them to draw any cause-and-effect conclusions, but suggest that “the presence of metabolic syndrome in a Type 2 diabetic patient is an independent alarm for renal involvement.”

“We expect interventional measures that improve metabolic control to aid in regression of microalbuminuria,” they conclude.

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