Association between Albuminuria, Glycated Hemoglobin with Comorbidities in Type 2 Diabetes Patients: Experience in Sulaimani City, Iraq

Hozan Jaza Hama Salh; Tavga Ahmed Aziz; Zheen Aorahman Ahmed; Taha Othman Mahwi

doi:10.54133/ajms.v6i1.380

Authors

Hozan Jaza Hama Salh Department of Clinical Pharmacy, College of Pharmacy, University of Sulaimani, Sulaimani, Kurdistan Region, Iraq https://orcid.org/0009-0003-1173-5512
Tavga Ahmed Aziz Department of Pharmacology and Toxicology, College of Pharmacy, University of Sulaimani, Kurdistan Region, Iraq https://orcid.org/0000-0003-2742-6127
Zheen Aorahman Ahmed Department of Pharmacology and Toxicology, College of Pharmacy, University of Sulaimani, Sulaimani, Kurdistan Region, Iraq https://orcid.org/0000-0003-4149-1566
Taha Othman Mahwi Department of Clinical Sciences, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq

DOI:

https://doi.org/10.54133/ajms.v6i1.380

Keywords:

Albuminuria, Comorbidities, HBA1c, Sulaimani City, Type 2 diabetes mellitus

Abstract

Background: Diabetes nephropathy is one of the most important complications of type 2 diabetes mellitus (T2DM). Albuminuria is an early clinical indicator for investigating diabetes nephropathy. Age, poor glycemic control, long duration of diabetes, and hypertension increase the risk of albuminuria. Objectives: To determine the relationship between albuminuria, HbA1c, and comorbidities in elderly patients with T2DM. Methods: A cross-sectional study was carried out on 136 elderly patients with T2DM at the Diabetes and Endocrine Center in Sulaimani City. Data was obtained from each patient through face-to-face interviews and laboratory tests for HbA1c, serum lipid profiles, and albumin levels in the urine. Results: Out of 136 patients, 82 elderly patients with T2DM were normoalbuminuric, 37 had microalbuminuria, and 17 had macroalbuminuria, respectively. The female gender was at greater risk of developing albuminuria (19.1% microalbuminuria and 6.6% macroalbuminuria) than the male gender (8% microalbuminuria and 5.8% macroalbuminuria). The risk factors for microalbuminuria and macroalbuminuria were poor glycemic control (HBA1c >7.5) (16.9% microalbuminuria and 6.6% macroalbuminuria), long-term diabetes (5–10 years) (13.9% microalbuminuria and 5.1% macroalbuminuria), and coexisting comorbidity conditions (21.3%) microalbuminuria and 10.2% macroalbuminuria, mainly hypertension (20.5% microalbuminuria and 8.8% macroalbuminuria). Conclusion: Our findings showed that the incidence of albuminuria in elderly patients with T2DM was high in patients with poor diabetes control, a long duration of diabetes, and comorbidity conditions, particularly in patients with hypertension.

Downloads

Download data is not yet available.

References

Upamali S, Rathnayake S. Perspectives of older people with uncontrolled type 2 diabetes mellitus towards medication adherence: A qualitative study. Plos one. 2023;18(8):1-18. doi: 10.1371/journal.pone.0289834.

Mansoori A, Sahranavard T, Hosseini ZS, Soflaei SS, Emrani N, Nazar E, et al. Prediction of type 2 diabetes mellitus using hematological factors based on machine learning, 17 approaches: a cohort study analysis. Sci Rep. 2023;13(1):1-11. doi: 10.1038/s41598-022-27340-2.

Papatheodorou K, Banach M, Bekiari E, Rizzo M, Edmonds M. Complications of diabetes 2017. J Diabetes Res. 2018;2018:1-4. doi: 10.1155/2018/3086167 .

Ramanathan RS. Correlation of duration, hypertension and glycemic control with microvascular complications of diabetes mellitus at a tertiary care hospital. J Neurol Exp Neural Sci. 2017;4(1):1-4. doi: 10.29011/JNNS-120.100020.

Ighodaro OM, Adeosun AM. Vascular complications in diabetes mellitus. Glob J Endocrinol Metab. 2017;1(2):1-3. doi: 10.31031/GJEM.2017.01.000506.

Ohiagu FO, Chikezie PC, Chikezie CM. Pathophysiology of diabetes mellitus complications: Metabolic events and control. Biomed Res Ther. 2021;8(3):4243-57. doi: 10.15419/bmrat.v8i3.663.

Maranta F, Cianfanelli L, Cianflone D. Glycaemic control and vascular complications in diabetes mellitus type 2. Adv Exp Med Biol. 2021;1307:129-152 doi: 10.1007/5584_2020_514.

Hu Q, Chen Y, Deng X, Li Y, Ma X, Zeng J, et al. Diabetic nephropathy: Focusing on pathological signals, clinical treatment, and dietary regulation. Biomed Pharmacother. 2023;159:1-16. doi: 10.1016/j.biopha.2023.114252.

Mohammed O, Alemayehu E, Bisetegn H, Debash H, Gedefie A, Ebrahim H, et al. Prevalence of microalbuminuria among diabetes patients in Africa: A systematic review and meta-analysis. Diabetes Metab Syndr Obes. 2023;16:2089-2103. doi: 10.2147/DMSO.S409483.

Karimifar M, Afsar J, Amini M, Moeinzadeh F, Feizi A, Aminorroaya A. The effect of linagliptin on microalbuminuria in patients with diabetic nephropathy: a randomized, double blinded clinical trial. Sci Rep. 2023;13(1):1-9. doi: 10.1038/s41598-023-30643-7.

Harahap RI, Tristina N, Anriani RR. Comparations of glycated albumin among type 2 diabetes mellitus patient with normoalbuminuria, microalbuminuria and macroalbuminuria. J Med Sci. 2023;17(1):53-58. doi: 10.26891/JIK.v17i1.2023.

Wang Y, Yuan A, Yu C. Correlation between microalbuminuria and cardiovascular events. Int J Clin Exp Med. 2013;6(10):973-978. PMCID: PMC3832337.

Rask-Madsen C, King GL. Vascular complications of diabetes: mechanisms of injury and protective factors. Cell Metab. 2013;17(1):20-33. doi: 10.1016/j.cmet.2012.11.012.

Chowdhury SK, Datta S, Mohith MT, Roy S, Hossain MJ, Zafrin N, et al. Study of relationship between HbA1c and microalbuminuria of diabetic patients. Ann Intern Med Dent Res. 2022;8(2):99-108. doi: 10.53339/aimdr.2022.8.2.14.

Martínez MM, Causillo TC, Agüero JE, Silva MG. Microalbuminuria as a marker of kidney damage in patients with diabetes mellitus. J Clin Med Rev. 2022;1(1):2836-2330. doi: 10.58489/2836-2330/001.

Jatoi NA, Said AH, Al-Ghamdi MS, Al-Abdulmhsin MF, Bin-Jaban RA, Al-Tayeb JA, et al. Prevalence of microalbuminuria and cardiovascular risk factors in patients with diabetes mellitus type-II in Al-Khobar, Kingdom of Saudi Arabia. Cureus. 2022;14(10):1-8. doi: 10.7759/cureus.29808.

Bhattarai T, Pandey A, Parajuli S, Khanal P, Dongol A, Devkota R, et al. Microalbuminuria among patients with diabetes mellitus visiting the department of nephrology in a tertiary care centre: A descriptive cross-sectional study. J Nepal Med Assoc. 2023;61(263):596-598. doi: 10.31729/jnma.8214.

Hu H, Zhao X, Jin X, Wang S, Liang W, Cong X. Efficacy and safety of eplerenone treatment for patients with diabetic nephropathy: a meta-analysis. PLoS One. 2022;17(3):1-16. doi: 10.1371/journal.pone.0265642.

Kim YJ, Hwang SW, Lee T, Lee JY, Uh Y. Association between urinary albumin creatinine ratio and cardiovascular disease. PLoS One. 2023;18(3):1-12. doi: 10.1371/journal.pone.0283083.

Ghimire P, Upadhyay HP. Albuminuria in patients with type 2 diabetes mellitus: a single center cross-sectional study. J Coll Med Sci Nepal. 2022;18(2):144-152. doi: 10.3126/jcmsn.v18i2.46099.

Khan TM, Nawaz FK, Karim MS, Shafique Z, Anwar MS, Usman O. Incidence of microalbuminuria and factors affecting it in patients with type 2 diabetes mellitus. Cureus. 2022;14(7):1-6. doi: 10.7759/cureus.27294.

Belli BG. Microalbuminuria in patients with type 2 Diabetes mellitus and its correlation with dyslipidemia. RGUHS J Med Sci. 2020;10(1):35-41. doi:10.26463/rjms.10_1_8.

Hussein NA. The prevalence of micro albuminuria in type 2 diabetes mellitus patients. Med J Babylon. 2014;11(4):984-93.

Lambers Heerspink HJ, Brantsma AH, de Zeeuw D, Bakker SJ, de Jong PE, et al. Albuminuria assessed from first-morning-void urine samples versus 24-hour urine collections as a predictor of cardiovascular morbidity and mortality. Am J Epidemiol. 2008;168(8):897-905. doi: 10.1093/aje/kwn209.

Iqbal A, Salman J, Habib J, Ali M, Naveed S, Ali A. Frequency of microalbuminuria and its relation to HbA1C in type 2 Diabetes mellitus patients. Professional Med J. 2023;30(02):199-203. doi: 10.29309/TPMJ/2023.30.02.6972.

Shikata K, Kodera R, Utsunomiya K, Koya D, Nishimura R, Miyamoto S, et al. Prevalence of albuminuria and renal dysfunction, and related clinical factors in Japanese patients with diabetes: The Japan Diabetes Complication and its Prevention prospective study 5. J Diabetes Investig. 2020;11(2):325-332. doi: 10.1111/jdi.13116.

Sana MA, Chaudhry M, Malik A, Iqbal N, Zakiuddin A, Abdullah M. Prevalence of microalbuminuria in type 2 diabetes mellitus. Cureus. 2020;12(12):1-4. doi: 10.7759/cureus.12318.

Al-Futaisi A, Al-Zakwani I, Almahrezi A, Al-Hajri R, Al-Hashmi L, Al-Muniri A, et al. Prevalence and predictors of microalbuminuria in patients with type 2 diabetes mellitus: a cross-sectional observational study in Oman. Diabetes Res Clin Pract. 2006;72(2):212-215. doi: 10.1016/j.diabres.2005.10.001.

Abdelwahid HA, Dahlan HM, Mojemamy GM, Darraj GH. Predictors of microalbuminuria and its relationship with glycemic control among type 2 diabetic patients of Jazan Armed Forces Hospital, southwestern Saudi Arabia. BMC Endocr Disord. 2022;22(1):1-8. doi: 10.1186/s12902-022-01232-y.

Al-Shammak AA, Ali AD, Jermozy HA. Prevalence of proteinuria among type 2 diabetic patients in Dhamar Governorate, Yemen. Int J Diabetes Clin Res. 2019;6(2):1-7. doi: 10.23937/2377-3634/1410106.

Tandon RK, Khare A, Gupta M, Nandwani S, Bansal R, Sharma S. Relationship between glycosylated hemoglobin and risk of microalbuminuria in patients with type 2 diabetes mellitus. People’s J Sci Res. 2015;8(1):14-18.

Al-Maskari F, El-Sadig M, Obineche E. Prevalence and determinants of microalbuminuria among diabetic patients in the United Arab Emirates. BMC Nephrol. 2008;9:1. doi: 10.1186/1471-2369-9-1.

Bae ES, Hur JY, Jang HS, Kim JS, Kang HS. Risk factors of microalbuminuria among patients with type 2 diabetes mellitus in Korea: A cross-sectional study based on 2019–2020 Korea National Health and Nutrition Examination Survey Data. Int J Environ Res Public Health. 2023;20(5):1-11. doi: 10.3390/ijerph20054169.

Aleidan AM, Al-Hamad E, Aleidan AM. Prevalence and gender difference in microalbuminuria among diabetic patients attending primary healthcare center at Security Forces Hospital, Riyadh, Saudi Arabia. Ann Clin Anal Med. 2023;10(1):232-239. doi: 10.4328/acam.v10i1.2.

Ali AA, Al Lami FH. Prevalence and determinants of microalbuminurea among type 2 diabetes mellitus patients, Baghdad, Iraq, 2013. Saudi J Kidney Dis Transpl. 2016;27(2):348-355. doi: 10.4103/1319-2442.178561.

Afkhami-Ardekani M, Modarresi M, Amirchaghmaghi E. Prevalence of microalbuminuria and its risk factors in type 2 diabetic patients. Indian J Nephrol. 2008;18(3):112-117. doi: 10.4103/0971-4065.43690.

Bamahel AS. Prevalence of diabetic nephropathy among type 2 diabetes mellitus patients in Mukalla City, Yemen. Enhanced Knowl Sci Technol. 2022;2(2):432-440. doi: doi: 10.30880/ekst.2022.02.02.046.

Nakhjavani M, Morteza A, Jenab Y, Ghaneei A, Esteghamati A, Karimi M, et al. Gender difference in albuminuria and ischemic heart disease in type 2 diabetes. Clin Med Res. 2012;10(2):51-56. doi: 10.3121/cmr.2011.1021.

Das SK, Patjoshi SK, Narayan CB, Nayak DR, Yadav RN. Assessment among type 2 diabetes mellitus relationship with albuminuria. Int J Acad Med Pharm. 2023;5(4):911-915. doi: 10.47009/jamp.2023.5.4.184.

Atalla AA, Abdullah AM, Turkistani AK, Aljawi MA, Al-Habashi AH. The prevalence and risk factors of micro and macroalbuminuria among diabetic patients in Taif. Mid East J Fam Med. 2022;21(1):299-303. doi: 10.5742/MEWFM.2023.95251599.

Lin YP. Albuminuria in hypertension. Hypertens Res. 2013;36(9):762-764. doi: 10.1038/hr.2013.76.

Li F, Chen QX, Peng B, Chen Y, Yao T, Wang G. Microalbuminuria in patients with acute ischemic stroke. Neurol Res. 2019;41(6):498-503. doi: 10.1080/01616412.2019.1576320.

Makino H, Haneda M, Babazono T, Moriya T, Ito S, Iwamoto Y, et al. Microalbuminuria reduction with telmisartan in normotensive and hypertensive Japanese patients with type 2 diabetes: a post-hoc analysis of The Incipient to Overt: Angiotensin II Blocker, Telmisartan, Investigation on Type 2 Diabetic Nephropathy (INNOVATION) study. Hypertens Res. 2008;31(4):657-664. doi: 10.1291/hypres.31.657.