Nephrology Dialysis Transplantation, Vol 12, Issue 12 2612-2617, Copyright © 1997 by Oxford University Press
O Wirta, A Pasternack, J Mustonen and P Laippala
Background: The objective was to evaluate the impact
of urinary albumin excretion rate (UAER), glomerular filtration rate (GFR)
and subclinical autonomic neuropathy (SANP) on 9-year total (TM) and sudden
cardiac mortality (SCM) in recently diagnosed (<1 year; RD; n=150)
and known (mean duration 11 years; KD; n=146) NIDDM subjects.
Methods: The study was prospective and controlled
(n=150). Mortality predictors were analysed by logistic regression
analysis. The dependent variables were TM and SCM, the predictors were
UAER, GFR, SANP, age, gender, BMI, mean arterial pressure (MAP), fasting
serum cholesterol, HDL-cholesterol, triglycerides, insulin, haemoglobin
A1c, diabetes duration, QTc-interval (ECG), coronary heart disease (CHD),
peripheral vascular disease (PVD), cerebrovascular disease (CVD),
congestive heart failure (CHF), antihypertensive therapy, and smoking
habits. Results: CHD predicted TM and SCM in both RD
(P=0.041 and 0.029) and KD (P=0.34 and 0.006). PVD predicted TM and SCM in
RD only (P=0.049), fasting serum cholesterol (P=0.007) and CHF (P=0.001)
predicted TM and in kDa haemoglobin Alc (P=0.004), age (P=0.001) and MAP
(P=0.014) predicted TM. Serum triglycerides predicted SCM in both RD and
kDa (P=0.001 and 0.003). SANP predicted TM (P=0.009) and SCM (P=0.044) in
KD only. GFR (inverse value) predicted TM and SCM (P=0.04 and 0.027) in kDa
only. The UAER did not predict mortality in the diabetic subjects.
Conclusion: SANP and a slightly reduced GFR still in
the normal range predicted mortality in KD. Microalbuminuria (30
<UAER <300 mg/24 h) did not independently predict 9-year
mortality in the NIDDM subjects studied. Key words:
autonomic neuropathy; glomerular filtration rate; mortality;
non-insulin-dependent diabetes; prospective study; urinary albumin
excretion rate
ORIGINAL ARTICLES
Renal and cardiovascular predictors of 9-year total and sudden cardiac mortality in non-insulin-dependent diabetic subjects
Department of Medicine, Tampere University Hospital, Finland; Medical school, University of Tampere, Finland; School of Public health, University of Tampere and Tampere University Hospital, Finland; Corresponding author at: Medical School, University of Tampere, PO Box 607, FIN-33101 Tampere, Finland
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