Abstract
Background: Microalbuminuria refers to the excretion of albumin in the urine at a rate that exceeds
normal limits but is less than the detection level for traditional dipstick methods and is considered as a marker
of diabetic nephropathy. Aims: To establish the prevalence of elevated urinary albumin levels
(microalbuminuria) in a sequential sample of diabetic patients and to determine its relationship with known
and putative risk factors, to ascertain relationship of serum angiotensin converting enzyme (ACE) activity with
diabetic incipient nephropathy. Study design: This cross-sectional analytical study included 100 control and 325
diabetic patients (180 type 2 and 145 type 1 diabetic patients) subjects attending outpatient department of
the hospital. Patients having clinical albuminuria and with other causes of proteinuria were excluded. Result:
Microalbuminuria was observed in 34.48% in patients with type 1 and 28.33% in patients with type 2 diabetes
mellitus respectively. Having the condition was significantly associated with advanced age, poor glycaemic
control, dyslipidemia (with respect to total cholesterol, triglycerides and LDL-C), smoking, body mass index and
coexisting hypertension. The duration of diabetes was a significant correlate in type 1 DM subjects only. No
significant association with gender, HDL-C levels, age at onset of DM, mode of treatment, socio-economic
status and other lifestyle variations was found. All clinical and biochemical parameters in patient with
microalbuminuria was more adversely affected than patients with normoalbuminuria. Serum angiotensin
converting enzyme (ACE) levels were significantly elevated (P<0.001) in both of the diabetic groups, moreover,
its levels were higher in subjects with microalbuminuria than in those without this complication (P<0.05).
Conclusions: Microalbuminuria in diabetes, which represents an earlier phase in the development of clinical
nephropathy, is associated with many potentially modifiable risk factors. In estimating diabetic nephropathy
risk, AER is most important and should be done frequently but there are gains to be made in predictive
precision by considering family history, smoking habits, glycemia, B.P.,BMI lipid levels and ACE activity. Early
screening for incipient diabetic nephropathy and aggressive management of these risk factors is important in
optimising the renal outcome of patients with diabetes mellitus.