NDT Advance Access published online on August 6, 2008
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfn447
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Socioeconomic status and microalbuminuria in an Asian population
1 Department of Community, Occupational, and Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore 2 Singapore National Eye Centre and Singapore Eye Research Institute 3 Alexandra Hospital 4 Singapore General Hospital, Singapore 5 Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia
Correspondence and offprint requests to: Anoop Shankar, Department of Community Medicine, West Virginia University School of Medicine, P.O. Box 9190, Morgantown, WV 26506-9190. Tel: (304) 293-0199; Fax: (304) 293-6685; E-mail: ashankar{at}hsc.wvu.edu
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Abstract |
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Background. In studies from developed Western countries, lower socioeconomic status (SES) has been reported to be associated with kidney diseases. However, this hypothesis has not been examined in populations from newly industrialized Asian countries. We evaluated the association between SES and micro/macroalbuminuria in a population-based sample in Singapore.
Methods. We examined 920 participants of Malay ethnicity aged 40–80 years (49.6% female). SES was defined through education, income and housing type of participants. The main outcome of interest was the presence of micro/macroalbuminuria defined as a urinary albumin-to-creatinine ratio (ACR) 
17 mg/g for men and 25 mg/g for women.
Results. Lower categories of SES were associated with micro/macroalbuminuria; compared to the higher categories of SES, the odds ratio (95% confidence interval) of micro/macroalbuminuria was 1.76 (1.23–2.52) for primary/lower education, 1.64 (1.16–2.31) for income <1000 Singapore dollars (SGD)/retired status, 1.44 (1.01–2.06) for small/medium housing type and 2.37 (1.56–3.60) for the coexistence of all three low SES factors (primary/ below education, income <1000 SGD/retired status and small/medium housing type) compared to 
1 low SES factor. This pattern of association was consistently present in subgroup analyses by gender and age.
Conclusions. Lower SES is associated with the presence of micro/macroalbuminuria independent of age, gender, smoking, alcohol intake and body mass index among Malay adults in Singapore.
Keywords: education; housing type; income; kidney disease; microalbuminuria
Received for publication: 9. 1.08
Accepted in revised form: 11. 7.08