Diabetes Care, Vol 18, Issue 12 1602-1605, Copyright © 1995 by American Diabetes Association

ARTICLES

Exercise testing as a long-term predictor of the development of microalbuminuria in normoalbuminuric IDDM patients

SF O'Brien, GF Watts, JK Powrie and KM Shaw
University Department of Medicine, University of Western Australia, Perth.

OBJECTIVE: To determine the association between exercise-induced albuminuria and the development of microalbuminuria over 10 years in subjects with insulin-dependent diabetes mellitus (IDDM) who were initially normoalbuminuric. RESEARCH DESIGN AND METHODS: Thirty-two patients with IDDM and a resting urinary albumin/creatinine ratio (UA/UC) < 2.1 mg/mmol (< 15 micrograms/min) were exercised after water loading on a treadmill for 20 min at double their resting heart rate. UA/UC was determined before and after exercise. The exercise test was considered positive if the UA/UC was > 4.3 mg/mmol (> 30 micrograms/min). Results were compared with resting UA/UC after a 10-year follow-up. Persistent microalbuminuria was defined as a UA/UC > 2.1 mg/mmol (> 15 micrograms/min) in each of two early-morning urine collections. RESULTS: Five patients developed persistent microalbuminuria after 10 years, and four patients were predicted by a positive exercise test. Two patients with positive exercise tests did not develop persistent microalbuminuria. The sensitivity of the exercise test for the development of microalbuminuria was 80% (95% confidence interval [CI] 65.8-94.2%) and the specificity was 92.9% (95% CI 83.9-100%). The postexercise UA/UC was positively associated with the UA/UC after 10 years (P = 0.005, R2 = 0.31). This association was independent of HbA1, systolic blood pressure, body mass index, and duration of diabetes, but HbA1 remained an independent predictor (P = 0.02) of UA/UC at follow-up. CONCLUSIONS: Exercise testing may be useful for identifying normoalbuminuric IDDM patients who are susceptible to the later development of microalbuminuria.
CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				U. Weis, B. Turner, J. Gibney, G.F. Watts, V. Burke, K.M. Shaw, and M.H. Cummings Long-term predictors of coronary artery disease and mortality in type 1 diabetes QJM, November 1, 2001; 94(11): 623 - 630. [Abstract] [Full Text] [PDF]