Urinary Albumin Creatinine Ratio has no Significant Association with Retinopathy in Individuals with Type 1 Diabetes Mellitus

Samih Abed Odhaib ¹ , Mahmood Thamer Altemimi² , Omer Mansib Kassid³ , Haider Ayad Alidrisi¹ , Nassar Taha Yaseen Alibrahim¹ , Ali Hussein Ali Alhamza¹ , Ahmed Sabah Budair¹ , Abbas Ali Mansour¹ 

¹Adult endocrinologist, Faiha Specialized Diabetes, Endocrine and Metabolism Center (FDEMC), Basrah Health Directorate, College of Medicine, University of Basrah, Basrah 61001, Iraq.

²Adult endocrinologist, Thi Qar Specialized Diabetes Endocrine and Metabolism Center (TDEMC), Thi Qar Health Directorate, Thi Qar, Iraq.

³Department of Medicine, College of Medicine, University of Misan, 62001 Misan, Iraq.

Corresponding Author E-mail: mahmoodaltimimi83@gmail.com

Abstract: Background The relationship between diabetic retinopathy (DR) and nephropathy in type 1 diabetes mellitus (T1DM) is controversial. This study assessed the utility of the spot urinary albumin creatinine ratio (UACR) as a parameter for correlating diabetic nephropathy with DR in individuals with T1DM in Basrah. Methods The study was a cross-sectional observational study of 216 patients with T1DM (16–49 years old) with different DR types. We used demographic variables, different T1DM-related variables (onset and duration of T1DM, glycemic control, latency between T1DM and DR onset, age of onset of DR), and biochemical investigations, such as spot UACR, renal function tests, glycated hemoglobin (HbA1c), anti-glutamic acid decarboxylase-65 (anti-GAD-65) antibody, lipid profile, and thyrotropin. We used ordinal regression analysis to test for the possible primary covariates and adjusted the findings with an analysis of covariates (ANCOVA). Results The patient population showed a slight male preponderance, and uncontrolled T1DM with high HbA1c was found in 93% of the cohort. The mean UACR was 64.37 ± 8.99 mg/g. Normal UACR levels were seen in approximately 60% of the cohort (n=129). Sixty-five individuals were reported to have DR, with a median age of onset of 34 ± 8 years and a median latency period of 13 ± 7 years. UACR had no significant relationship with DR development at any association level, with or without adjustment for the composite regression factors. Conclusion There was no significant association between UACR at any level and DR development before and after adjustment for all of the possible covariates in this study.

Keywords: Albuminuria; Basrah; diabetic nephropathy; diabetic retinopathy; type 1 diabetes mellitus; urinary albumin-creatinine ratio

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