Muhammad Saiedullah,1* Aradhan Sarkar,1 Shoma Hayat,1 Muhammad Rezwanur Rahman,2 Md.

Tahminur Rahman,3 Farhana Jamal 4

1 2

Comparison of urine albumin creatinine ratio among controlled, moderately controlled and uncontrolled diabetic patients

Department of Biochemistry, Bangladesh Institute of Health Sciences, Mirpur, Dhaka, Bangladesh. Department of Biochemistry, Delta Medical College, Mirpur, Dhaka, Bangladesh. 3 Department of Pathology, Ibrahim Medical College, Shahbag, Dhaka, Bangladesh. 4 Department of Pharmacy, University of Development Alternative, Dhanmondi, Dhaka, Bangladesh.

Bangladesh J Pathol 2010;25:3-6

Abstract: Urine albumin creatinine ratio (UACR) has been established as a valuable risk marker for renal and cardiovascular complications. The incidence of macro and microvascular complications is higher in diabetic subjects. In this study we aimed to compare urinary albumin creatinine ratio among controlled, moderately controlled and uncontrolled diabetic subjects to explore the association of glycosylated hemoglobin A1c (HbA1c) with UACR. HbA1c and UACR were measured in 345 diabetic subjects and subjects were grouped in to three categories depending on HbA1c values. UACR was compared among different diabetic groups and also between different sex and age groups. Significant difference of mean UACR was found among controlled, moderately controlled and uncontrolled diabetic subjects (P<0.05). But UACR did not differ significantly in different sex and age groups. Percentage of subjects having UACR above the cut-off value increased with the increase of HbA1c. The study also revealed that the incidence of microalbuminurea is higher in uncontrolled diabetes than controlled diabetic subjects.
Key words: Microvascular complications, Glycated Hemoglobin (HbA1c), Urine albumin creatinine ratio (UACR). Non standard abbreviations: DM, Diabetes Mellitus; UACR, Urine Albumin Creatinine Ratio; HPLC, High Performance Liquid Chromatography; IHD, Ischemic Heart Disease.

Introduction Diabetes mellitus (DM) is associated with long term damage, dysfunction and failure of various organs, especially the eyes, kidneys, nerves, heart and blood vessels (1). Diabetic nephropathy is the leading cause of premature deaths in diabetic patients, with deaths related to cardiovascular disease (CVD) as well as renal failure (2). The excretion of small

amount of albumin in the urine has been documented to predict renal failure and cardiovascular morbidity as well as mortality in diabetics (3,4). Glycosylated hemoglobin A1c and albumin creatinine ratio (ACR) are significantly increased in diabetic patients (5). Glycosylated hemoglobin (HbA1c) is commonly used as a marker of glycaemic status. HbA1c has been proposed as a dual