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Am J Physiol Renal Physiol 286: F442-F450, 2004; doi:10.1152/ajprenal.00247.2003
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INVITED REVIEW

Microalbuminuria as a marker of cardiovascular and renal risk in type 2 diabetes mellitus: a temporal perspective

James T. Lane

Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska 68198-3020

Microalbuminuria is a marker for diabetic nephropathy. It also signifies cardiovascular disease, as well as nephropathy, in type 2 diabetes (DM2). Microalbuminuria may precede DM2, occurring with the insulin resistance syndrome and its components, including obesity and hypertension. Other indicators of cardiovascular risk, such as markers of inflammation, are associated with microalbuminuria in populations of patients with and without diabetes. With the rising prevalence of DM2 in minority youth, especially in Native Americans, a marker for future disease risk would allow earlier prevention strategies to be tested. Before microalbuminuria can be used in a prevention strategy, more needs to be known about the mechanism(s) of the association between elevated excretion, its relationship to glucose intolerance, and its relative contribution to cardiovascular and renal disease. These questions are especially applicable as we begin to observe the long-term complications of diabetes in youth.

insulin resistance; American Indians; young adults


Address for reprint requests and other correspondence: J. T. Lane, Dept. of Medicine, Nebraska Medical Center, Omaha, NE 68198-3020 (E-mail: jtlane1{at}unmc.edu).




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