(20-02-11) The Cross-Sectional Associations of Albuminuria and C-Reactive Protein With Functional Disability in Older Adults With Diabetes.

Kuo HK, Al Snih S, Kuo YF, Raji MA.
Department of Internal Medicine, University of Texas Medical Branch,
Galveston, Texas.

Abstract
OBJECTIVE To examine the relationship between albuminuria, inflammation, and
disability in older adults with diabetes. RESEARCH DESIGN AND METHODS Data were
from 1,729 adults (??60 years) with diabetes in the National Health and
Nutrition Examination Survey, 1999-2008. Disability in activities of daily
living (ADL), instrumental activities of daily living (IADL), leisure and
social activities (LSA), general physical activities (GPA), and lower-extremity
mobility (LEM) was obtained from self-reports. Urinary albumin-to-creatinine
ratio (UACR) (mg/g) was categorized into normal (UACR <30 mg/g),
microalbuminuria (UACR 30-300 mg/g), and macroalbuminuria (UACR >300 mg/g). C-
reactive protein (CRP) levels were quantified by latex-enhanced nephelometry.
RESULTS In the full-adjusted model, microalbuminuria was associated with
disability in ADL, LSA, and LEM with corresponding odds ratios (ORs) (95% CIs)
of 1.51 (1.16-1.98), 1.62 (1.23-2.14), and 1.34 (1.03-1.74), respectively,
compared with participants without albuminuria. Macroalbuminuria was associated
with disability in ADL, IADL, and LEM with corresponding ORs (95% CIs) of 1.94
(1.24-3.03), 1.93 (1.23-3.02), and 2.20 (1.38-3.49), respectively, compared
with participants without albuminuria. Elevated CRP (>0.3 mg/dL) was associated
with increased odds of disability in ADL and LEM, with corresponding ORs (95%
CIs) of 1.28 (1.00-1.62) and 1.68 (1.34-2.11), respectively. Subjects with both
albuminuria and elevated CRP had higher odds of disability than individuals
with no albuminuria and normal CRP. CONCLUSIONS Albuminuria and inflammation
were independent correlates for disability among older adults with diabetes.
There was an interaction of albuminuria and elevated CRP on disability,
suggesting that the presence of subclinical inflammation may amplify the effect
of albuminuria on disability in older adults living with diabetes.


Sources:
Diabetes Care. 2011 Feb 7. [Epub ahead of print]
PMID: 21300788 [PubMed - as supplied by publisher]

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