Korean Diabetes Journal 2002;26(6):500-508.
Published online December 1, 2002.
Left Ventricular Mass Index Increases in Proportion to the Urinary Microalbumin Excretion Rate in Type 2 Diabetes.
Seung Ha Park, Won Young Lee, Sun Woo Kim
Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
In type 2 diabetes, microalbuminuria is an early marker of the atherosclerotic process and of endothelial dysfunction. It has also been shown to be related with the prevalence and morbidity of renal and cardiovascular diseases, and is associated with other risk factors of vascular damage. Left ventricular hypertrophy (LVH) has long been established as a major independent marker of future cardiovascular morbidity and mortality, depending on the body mass and blood pressure load. In order to clarify any association between the urinary microalbumin excretion rate (UAER) and the left ventricular mass index (LVMI), which may explain the observed poor prognosis in these patients, we analysed the clinical characteristics and laboratory findings data of type 2 diabetes. METHODS: We conducted a cross-sectional study of 48 patients with type 2 diabetes, who had been echocardiographically assessed and their 24-h urine collection analyzed for UAER, and the patients with clinical evidence of heart and renal diseases were excluded. The patients were divided into two groups according to their mean LVMI value (Low LVMI group: LVMI <97 g/m2, n=26; High LVMI group: LVMI >or=97 g/m2, n=22). RESULTS: The UAER, and systolic and diastolic blood pressures, were higher in the High LVMI group, but age, sex, body mass index (BMI) and duration of diabetes were similar in both group. The correlation of UAER and systolic blood pressure with LVMI remained significant, even after a multiple regression analysis (p=0.042, p=0.01 respectively). CONCLUSION: The significant relationship between the UAER and LVMI was independent of blood pressure, age, sex, BMI, duration of diabetes and other cardiovascular risk factors in type 2 diabetes. Therefore, an increased UAER may play an important role in the development of LVH.
Key Words: Microalbuminuria, Left ventricular mass index, Left ventricular hypertrophy, Type 2 diabetes mellitus

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