INCIDENCE AND DETERMINANTS OF ELEVATED URINARY ALBUMIN EXCRETION IN PIMA-INDIANS WITH NIDDM

OBJECTIVE- To examine the incidence and determinants of elevated urinary albumin excretion in Pima Indians with non-insulin-dependent diabetes mellitus (NIDDM). RESEARCH DESIGN IND METHODS- The incidence of elevated urinary albumin excretion (greater than or equal to 30 mg albumin/g creatinine) and its relationship with baseline characteristics was determined in 456 Pima Indians greater than or equal to 15 years old with NIDDM who were followed for up to 11.6 years (median 4.7 years). RESULTS- Of these 456 subjects, 192 (42%; 58 men, 134 women) developed elevated urinary albumin excretion, 172 of whom (90%) were within the microalbuminuric range (30-299 mg/g). The incidence of elevated urinary albumin excretion was related to retinopathy, type of diabetes treatment, longer duration of diabetes, lower body mass index, and higher values of mean arterial pressure, HbA,, and fasting and 2-h postload plasma glucose concentration at the baseline examination, but not to sex. A relationship with cholesterol was found in durations of diabetes of greater than or equal to 10 years. The cumulative incidence of elevated albumin excretion was 17% after 5 years of NIDDM. CONCLUSIONS- The incidence of elevated urinary albumin excretion in Pima Indians with NIDDM is at least as high as that reported previously in insulin-dependent diabetes mellitus, and its major determinants are the same as those shown previously to predict the development of more advanced renal disease in this population.