2019, Vol. 1, Issue 2, Part B

Background: Microalbuminuria is an established marker of diabetic nephropathy. Microalbuminuria is thought to be the consequence of generalized endothelial damage along the vascular tree. Microalbuminuria is defined as an excretion of albumin in the urine, amount ranging from 30 to 300 mg/day or 20 to 200 mg/L. It begins insidiously and may precede the diagnosis of type 2 DM. It is at this stage that one can hope to reverse diabetic nephropathy or prevent its progression. Hyperglycaemia contributes largely to the development of endothelial dysfunction in diabetes and ultimately leads to albumin loss. The prevalence of hypercholesterolemia (TC>200md/dl) alone, as reported in numerous studies across India, has varied from about 20% to 35%. However, what is more important is the pattern of dyslipidemia. When compared with the western populations, Indians and migrant Asian Indians tend to have higher triglyceride levels and lower HDL-C levels.

Materials and Methods: This was a comparative study conducted RKDF Medical College Hospital & Research Center, Bhopal, Madhya Pradesh, India among 120 cases. A pre-structural proforma will be used to collect baseline date detailed clinical history with clinical examination and relevant investigation will be done on participating individuals. The patients and controls were screened for fasting blood sugar (FBS), lipid profile, and microalbuminuria and the values were compared with that of normal healthy subjects. Microalbumin in urine was estimated by Nycocard Reader (Diabetes Care 1997) GFR was estimated from serum creatinine using the Modification of Diet in Renal Disease (MDRD) equation.

Results: A higher incidence and prevalence of renal failure particularly in nondiabetic renal patients is observed in men. According to Silbiger and Neugarten, the ratio between men and women that reaches renal insufficiency due to hypertensive nephropathy or glomerulonephritis is 1.6 men for each woman affected. There was correlation between lipid levels and duration of diabetes for all lipid fractions which were significant.

Conclusion: In type 2 diabetic patients, microalbuminuria is significantly associated with elevated serum total cholesterol, triglyceride and decreased levels of HDL. Thus, microalbuminuria is an indication for screening for possible vascular disease and aggressive intervention to reduce all cardiovascular risk factors (e.g. lowering of LDL cholesterol, antihypertensive therapy, cessation of smoking, institution of exercise etc). This study may also highlight the importance of proper glycemic control in arresting the progression of inflammation Correlation coefficient between nephropathy and lipid profile was found to be significant.