#Proteinuria as a Significant Predictive Factor for the Progression of Carotid Artery #Atherosclerosis in Non-Albuminuric Type 2 #Diabetes

The purpose of this study was to evaluate whether the urine protein to creatinine ratio (uPCR) has have clinical significance in relation to cardiovascular risk associated with carotid artery intima-media thickness (cIMT) progression, in subjects with type 2 diabetes and normoalbuminuria.

In this retrospective longitudinal study on T2D, we recruited 927 subjects with normoalbuminuria (urine albumin to creatinine ratio [uACR] < 30 mg/g) whose cIMT was measured at baseline and at least 1 year later, and whose initial urine protein to creatinine ratio (PCR) and ACR data were available.

Higher initial uPCR was positively correlated with a greater increment in maximal cIMT (β=0.074, p=0.028), and this correlation was significant even after adjusting for multiple confounding factors (β=0.074, p=0.046). High baseline uPCR was an independent predictive factor for the increased risk of maximal cIMT progression in a simple logistic regression model (OR, 1.41; 95% CI, [1.08-1.86]; p=0.013). Even after adjusting for several confounding variables, higher uPCR was significantly associated with a higher risk of cIMT progression (OR, 1.48; 95% CI, [1.08−2.03]; p=0.014).

These results suggest that high uPCR may be a useful predictive marker for the progression of carotid artery atherosclerosis, even in subjects with T2D and without albuminuria.