Background: It is unclear how hyperglycemia severity & control impact the likelihood of microalbuminuria (MA) , an early sign of microvascular damage, across different races/ethnicities.

Methods: We included 14,355 adults aged ≥20 years with eGFR ≥60 ml/min/1.73 m2, urine albumin-creatinine ratio (ACR) <300 mg/g, and without CVD from the 2011-2018 National Health and Nutrition Examination Surveys. MA was defined in this study as ACR ≥20 mg/g. We assessed the impact of HbA1c% (divided into sextiles) , disease stage, and diabetes (DM) control, on odds of MA using multivariable logistic regression, adjusting for covariates, accounting for survey design, and stratifying by race/ethnicity (Table) .

Results: Across all race/ethnicities, prediabetes, controlled & uncontrolled DM, and untreated DM were associated with increased odds of MA, albeit of varying significance (Table) . Asians with prediabetes had 46% higher adjusted odds of MA. DM control modified the effect of DM on odds of MA (p-interaction <0.001) . There was a dose-dependent increase in MA with increasing sextile of HbA1c% (p-trend<0.0001) . The increase in MA was significant at HbA1c%≥5.4% among Hispanics and Asians, ≥5.6% among Whites, and ≥6.0% among Blacks (Table) .

Conclusions: Patients with prediabetes may have increased likelihood of MA, with potentially lower HbA1c thresholds among Asian American and Hispanic adults.


A.Visaria: None. F.Hameed: None. S.Reddy: None. B.A.Raval: None. A.Sharma: None. B.Nagaraj: None.

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