Wang Q, et al. - Given microalbuminuria (MA) has been demonstrated as a biomarker for microvascular dysfunction, researchers assessed the link between glycemic status and MA in prehypertensive and ideal BP subjects. They also assessed if the interaction between glycemic and blood pressure status confers risk for MA prevalence. Findings revealed a statistically significant link between diabetes and microalbuminuria only in prehypertensive subjects. They also found that the interaction between perhypertension and diabetes conferred risk for MA.

Methods

• This study included a total of 1059 subjects aged 40-70 with non-hypertension who were recruited from 6 districts of Tianjin.
• Participants were divided into prehypertensive group (622 cases) and ideal blood BP (437 cases).
• Further classification of subjects of prehypertensive group and ideal BP group into 3 subgroups was done respectively: normoglycemia subgroup, prediabetes subgroup and diabetes subgroup.
• Researchers evaluated the prevalence of MA in the above 3 subgroups of subjects with prehypertension and ideal BP.
• Using a multivariate logistic regression model, a statistical analysis was performed including overall study sample for interaction test between glycemia and BP status on microalbuminuria.
• They assessed the association of glycemic status (defined as normoglycaemia, prediabetes, and diabetes) with MA separately in prehypertensive and ideal BP subjects.

Results

• They noted a rise in the prevalence of MA in both prehypertensive and ideal BP groups as the classification of glycemic level of subgroups increased (32.6%, 18.3%, 14.8% vs. 23.1%, 16.2%, 13.4%), the differences in prehypertensive group were statistically significant(Pearson Χ²=15.24, P < 0.001).
• In the fully adjusted model, the observed ORs (95% CI) of MA were 1.25 (0.86~1.83) for prediabetes and 2.56 (1.62~4.03) for diabetes.
• Findings demonstrated no interaction between prediabetes and BP status with respect to MA (P=0.237) but a significant interaction was observed between diabetes and BP status (P<0.001).
• A significant association of the diabetes subgroup with MA was demonstrated by multivariate logistic regression models in prehypertensive group, and the adjusted odd ratio of the diabetes subgroup to the normoglycemia subgroup was 2.68 (95%CI 1.54~4.67) (P < 0.001).
• However, in ideal BP group, no significant association of glycemic status with MA was evident.
• Relative to those with ideal BP and normoglycemia(reference group), the highested risk of MA (adjusted OR=2.50 , 95%CI 1.16~5.36; P=0.019) was observed in people with both perhypertension and diabetes, as revealed in stratified analysis by a multivariate logistic regression model in the whole study population.