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Query: UMLS:C0042373 (vascular disease)
 17,070 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Non-insulin-dependent diabetes is associated with a 2-3 fold increased risk of cardiovascular disease. The poor relationship between this risk and either glycaemic control or diabetes duration suggests that some other aspect of the diabetic state, and not hyperglycaemia per se, mediates this risk. This other aspect of diabetes does not comprise alterations in recognized cardiovascular risk factors such as blood pressure or lipids, as the major component of the excess risk is in those diabetics with low levels of the other risk factors. It thus appears that there may be some factors that predispose both to diabetes and to cardiovascular disease. In insulin-dependent diabetics most of the excess risk of cardiovascular disease occurs in subjects with proteinuria, and microalbuminuria or proteinuria in non-insulin-dependent diabetics also substantially increases cardiovascular risk. Although changes in recognized risk factors in diabetics with nephropathy may partly explain these observations, we and others have shown that microalbuminuric non-diabetics also have a markedly increased prevalence of cardiovascular disease and substantially increased cardiovascular mortality. The observations that in insulin-dependent diabetics nephropathy shows family clustering and that these patients have elevated sodium lithium counter-transport rate, a possible genetic marker for the vascular complications of hypertension, have led to the suggestion that microalbuminuria may be a marker of a genetic predisposition to vascular disease.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Microalbuminuria: a genetic link between diabetes and cardiovascular disease? 148 48

A prospective study was performed to determine urinary albumin excretion in a group of 28 patients with systemic sclerosis. At the initial screen one patient had proteinuria and three had microalbuminuria. One year later these abnormalities persisted and in two of of the patients serum creatinine had significantly increased. In addition, a further three patients had developed microalbuminuria. In a control group of 10 patients with primary Raynaud's disease none had microalbuminuria. In a second control group of 16 patients with unrelated skin diseases one patient had microalbuminuria and one proteinuria, but both these patients had a history of hypertension. It is concluded that microalbuminuria is more common in patients with systemic sclerosis than in patients of equivalent age with other dermatological conditions but no vascular disease.
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PMID:Microalbuminuria in systemic sclerosis. 157 87

In non-insulin-dependent diabetes mellitus (NIDDM) patients, microalbuminuria predicts early mortality, predominantly from cardiovascular disease. Increased free radical activity and abnormalities in hemostasis have been implicated in the development of vascular disease. Therefore, we measured markers of free radical activity (nonperoxide-conjugated diene isomer of linoleic acid [PL-9,11-LA'] and lipid peroxides expressed as malondialdehyde [MDA]) along with the hemostatic variables: fibrinogen, von Willebrand factor (vWf), plasminogen activator inhibitor (PAI-1), tissue plasminogen activator (t-PA), and plasmin activity (B beta 15-42) in 24 NIDDM patients (12 patients with microalbuminuria and 12 without microalbuminuria) and in 12 age-matched control subjects. There were no differences in linoleic acid (PL-9,12-LA) concentrations between the three groups. PL-9,11-LA' was elevated in the microalbuminuric patients compared with control subjects (P less than 0.05), but there was no difference between the two diabetic groups. MDA was elevated in the microalbuminuric diabetic patients compared with those patients without microalbuminuria (P less than 0.05) and control subjects (P less than 0.001). MDA was also increased in the patients without microalbuminuria compared with control subjects (P less than 0.01). Except for B beta 15-42, all the hemostatic variables were increased (P less than 0.05) in the diabetic patients compared with control subjects. The microalbuminuric diabetic patients had further increases in vWf (P less than 0.03) and t-PA (P less than 0.03) compared with patients with microalbuminuria. Our study suggests that there is an increase in free radical activity and abnormalities in hemostatic variables favoring a hypercoagulable state in NIDDM, especially in those with microalbuminuria.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Free radical activity and hemostatic factors in NIDDM patients with and without microalbuminuria. 162 64

To assess the predictive value of microalbuminuria (M) for diabetic macro- and microangiopathy, neuropathy and some related risk factors studies were carried out in 105 diabetic subjects. All examinations were repeated after one year. Microalbuminuria was found to parallel all late diabetic complications, at the beginning of investigations and also after a one-year evolution. It also positively correlated with some risk factors for angiopathy, such as plasma lipid parameters, blood pressure, body mass index and duration of disease.
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PMID:Microalbuminuria, as predictor of late diabetic complications. A prospective study. 227 Apr 22

The aim of this study was to assess and compare microalbuminuria (mu Alb mg/24 h +/- SD) in populations with hypertension and or diabetes mellitus leading to determine the effects of each pathology and their association in nephropathy. In hospital population studies were (mean +/- S.D.): (table; see text) No other pathology was found. Creatinine was in normal limits and macroproteinuria less than 1 g/24 h. Microalbuminuria was measured with laser immunonephelemetry. Glucose tolerance was assessed by fructosaminemia values (N less than or equal to 2.8 mmol/l). Student's test and linear regression test were used. There was no correlation between microalbuminuria and the other parameters: fructosamine, creatinine, age, in the 5 groups. Early nephropathy defined as a value of microalbuminuria between 30 and 300 mg/24 h was found in 23 p. 100 (H), mean 64.4 mg/24 h +/- 44, 37 p. 100 (D1), mean 127.7 +/- 149, 29 p. 100 (D2) mean 95.5 +/- 88, 47 p. 100 (D1H) mean 96.8 +/- 72, 39 p. 100 (D2H) mean 90 +/- 70. Microalbuminurias in diabetic populations were upper than in hypertensive (NS). Early nephropathy was most frequent when hypertension was associated with diabetes. Follow-up and treatment of hypertension in populations at high risk of vascular disease, as diabetics, will probably decrease the prevalence of early nephropathy.
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PMID:[Roles of arterial hypertension and diabetes mellitus in early nephropathy]. 251 Jun 49

Microalbuminuria was recently proposed as a novel atherogenic risk factor. The pathophysiological link between microalbuminuria and atherosclerosis may be mediated through an increased generalized transvascular leakage of albumin. To investigate this hypothesis, urinary albumin excretion and clearance and systemic transvascular albumin leakage (TERalb) were measured in 23 patients with severe clinical atherosclerosis and 25 healthy controls. In addition, renal clearances of three other endogenous plasma proteins (IgG, IgG4, and beta 2-microglobulin) and of creatinine were measured. Measurements of urine and serum proteins were done by enzyme-linked immunosorbent assays. TERalb was measured by the fractional disappearance rate of 125I-albumin from the total intravascular compartment in 1 hour after intravenous injection. Glomerular filtration rate was estimated as creatinine clearance. Urinary albumin excretion (geometric means [95% confidence intervals], 10.5 [6.1 to 18.3] versus 5.7 [4.7 to 6.9] micrograms/min; P < .05), fractional urinary albumin clearance (2.8 [1.6 to 4.8] x 10(-6) versus 1.3 [1.0 to 1.6] x 10(-6); P < .05), and TERalb (6.0 [5.5 to 6.5] versus 5.1 [4.5 to 5.8] %/h; P < .05) were higher in patients than in control subjects. Glomerular charge selectivity (ratio of IgG clearance to IgG4 clearance) was lower in patients than in control subjects (1.5 [1.1 to 2.0] versus 2.3 [2.0 to 2.6]; P < .05). These alterations were independent of blood pressure, glomerular filtration rate, tubular function, and smoking status. It is concluded that atherosclerotic vascular disease is associated with renal and systemic transvascular leakiness for albumin. Theoretically, such leakiness may in addition allow for an increased lipid insudation into the large vessel wall, thereby linking microalbuminuria to atherogenesis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Renal and systemic transvascular albumin leakage in severe atherosclerosis. 767 Sep 45

1. Microalbuminuria in non-diabetic elderly subjects is predictive of vascular disease and mortality, and related to levels of blood pressure. 2. This study was designed to examine whether more restricted periods of urine collection retained the relation to the prevailing level of blood pressure and successfully identified subjects with microalbuminuria. 3. Fifty elderly subjects (aged over 60 years) made two consecutive 24-h urine collections for measurement of urinary albumin excretion, divided between daytime and night-time periods. Thirty-three subjects also provided a random 'spot' urine sample. Clinic and 24-h ambulatory blood pressure were also recorded. 4. Median 24-h urinary albumin excretion was 15.75 mg; 17 subjects had microalbuminuria. The median 24-h albumin-creatinine ratio was 1.91 mg/mmol. A threshold albumin-creatinine ratio of > or = 3.0 mg/mmol in a random urine sample predicted microalbuminuria with 92% sensitivity and 90% specificity. Alternatively, threshold values of 2.5 mg/mmol for men and 4.5 mg/mmol for women in an overnight urine collection predicted microalbuminuria with 88% sensitivity and 100% specificity. 5. The closest relation between albumin-creatinine ratio and blood pressure was that between spot albumin-creatinine ratio and clinic systolic blood pressure (r = 0.64, P < 0.001). Albumin-creatinine ratio was generally related to clinic systolic blood pressure, diastolic blood pressure and ambulatory systolic blood pressure. Microalbuminuric subjects had significantly higher levels of clinic and ambulatory systolic blood pressure than non-microalbuminuric subjects. 6. Microalbuminuria in the elderly is most related to clinic systolic blood pressure.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Screening tests for microalbuminuria in non-diabetic elderly subjects and their relation to blood pressure. 772 Mar 43

Increased morbidity and mortality from atherosclerotic vascular disease were observed in subjects with slightly elevated urinary albumin excretion rate (UAER), known as microalbuminuria. Therefore, the association between microalbuminuria and established atherogenic risk factors was studied in clinically healthy subjects. All healthy 40-65 year-old participants with microalbuminuria, examined within the first 21 months of The Copenhagen City Heart Study, were invited, and 28 were studied. An age- and sex-matched group of 60 randomly chosen subjects with normoalbuminuria served as control. Microalbuminuria was defined as a UAER of 6.6-150 micrograms/min, and normoalbuminuria as a UAER < or = 6.6 micrograms/min. In the microalbuminuric group, systolic and diastolic blood pressures were both elevated (mean (95% C.I.) 128 (123-134) vs. 119 (116-122) mmHg; P = 0.005, and 75 (71-78) vs. 69 (67-71) mmHg; P = 0.008, respectively), and serum apolipoprotein (apo) A-1 concentration was lower (1.30 (1.20-1.37) vs. 1.42 (1.36-1.47) milligrams; P = 0.02) in comparison with the normoalbuminuric group. Furthermore, serum HDL-cholesterol concentration tended to be lower, whereas body weight, body mass index and fasting serum insulin concentration were slightly elevated in the microalbuminuric group but not statistically significant. It is concluded that microalbuminuria in clinically healthy subjects is associated with increased levels of atherogenic risk factors. This may contribute to the increased vascular morbidity and mortality observed in these individuals.
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PMID:Atherosclerotic risk factors are increased in clinically healthy subjects with microalbuminuria. 777 83

Microalbuminuria, i.e., slightly elevated urinary albumin excretion rate (UAER), notifies increased risk for atherosclerotic disease and may reflect an early generalized vascular abnormality in healthy subjects. This study was designed in order to examine whether such abnormality is associated with a shift of the haemostatic balance in prothrombotic direction. The following haemostatic factors were measured in two representative groups of clinically healthy subjects, 28 with microalbuminuria (UAER of 6.6-150 micrograms/min) and 60 age- and sex-matched controls with normoalbuminuria (UAER < 6.6 micrograms/min): Coagulation factors: blood platelet count and mean volume, plasma Factor VII antigen concentration and coagulant activity, and plasma concentrations of prothrombin fragment 1 + 2, thrombin-antithrombin III complexes, fibrinogen, and fibrinopeptide A; fibrinolytic and endothelial factors: plasma concentrations of tissue plasminogen activator antigen and plasminogen activator inhibitor type 1 antigen; and endothelial factor: plasma von Willebrand factor antigen concentration. The fibrinolytic and endothelial factors were measured both before and after 10 minutes of venous occlusion of the arm. None of the haemostatic factors were significantly altered in the microalbuminuric group. Plasma fibrinogen concentration tended to be elevated but not statistically significant ((mean (95% C.I.) 7.8 (7.2-8.3) vs. 7.2 (6.9-7.5) mumol/l; p < 0.1). Neither did any of the haemostatic factors correlate with UAER in regression analyses. It is concluded that the haemostatic balance is unaltered in healthy subjects with microalbuminuria. It is unlikely that a prothrombotic state is present as an intermedial factor early in a causal chain between microalbuminuria and atherosclerotic vascular disease.
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PMID:Aspects of haemostatic function in healthy subjects with microalbuminuria--a potential atherosclerotic risk factor. 777 57

Microalbuminuria and its association with vascular disease has previously been reported in nondiabetic individuals. The aims of this study were to determine whether there is a cross-sectional relationship between urinary albumin excretion rate and cardiovascular disease in nondiabetic subjects and to investigate hereditary predisposition to microalbuminuria by studying offspring of the main study population. Europid patients, aged 40-70 years, were randomly selected from a large inner-city general practice; there was a 62.6% attendance rate, and a study population of 959 remained after exclusions. Blood pressure, ankle systolic pressure, height, and weight were measured. Albumin excretion rate was calculated from overnight and morning urine collections. Venous blood was taken for lipids, fibrinogen, and factor VII; and resting electrocardiograms were carried out. Offspring (aged 15-40 years) of those found to be microalbuminuric were invited to attend for the same tests, and controls were selected by age and sex matching the parents. There was no association between parents' albumin excretion rate with that of their offspring, and there were no significant differences in albumin excretion rate between offspring subjects and their controls. There were no statistically significant associations of prevalent coronary heart disease (CHD) with albumin excretion rate or microalbuminuria in either sex [CHD in women: odds ratio (OR) 1.85; 95% confidence interval (CI) 0.19,9.0] [CHD in men: OR 2.13; 95% CI (0.64, 6.59)]. In women, there were significant associations between albumin excretion rate and peripheral vascular disease (positive) and fibrinogen (negative). Because established risk factors may not be as strongly associated with CHD in cross-sectional studies, we intend to follow this group prospectively.
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PMID:Associations of urinary albumin excretion rate with vascular disease in europid nondiabetic subjects. 808 57


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