Objectives: Recently, microalbuminuria (MA), a marker of advanced renal failure, has been shown to be related with cardiovascular disease especially in diabetic patients. This study was designed to investigate the relationship between MA and left ventricular functions and silent myocardial ischemia documented by exercise test in patients with type 2 diabetes mellitus.
Study design: The study included 50 asymptomatic patients (36 women, 14 men; mean age 63+/-7 years) with type 2 diabetes. All the patients underwent treadmill test and biochemical tests following transthoracic echocardiography. Microalbuminuria was diagnosed from a 24-hour urine sample on two different days and the patients were evaluated in two groups based on the presence (= or >30 mg/dl) or absence (<30 mg/dl) of MA.
Results: Twelve patients (24%) were found to have MA. There were no significant differences between patients with and without (n=38; 76%) MA with regard to age, sex, blood pressure, cardiovascular risk factors, plasma glucose, cholesterol, and triglyceride levels, and parameters of renal function (p>0.05). The duration of diabetes was significantly longer in patients with MA (p=0.03). Echocardiographic findings showed no significant differences in left ventricular systolic and diastolic functions between patients with and without MA (p>0.05). Exercise test revealed ischemic changes in 21 patients (42%). The incidence of silent myocardial ischemia was significantly higher among patients with MA (9/12 and 75% vs. 12/38 and 31.6%, p<0.001).
Conclusion: Our data suggest that MA can be used as an important marker for coronary artery disease in patients with diabetes mellitus.