432-P: Single and Joint Impact of Type 2 Diabetes and of Coronary Artery Disease on Albuminuria

Albuminuria is a characteristic feature of diabetic nephropathy, and increased urine albumin excretion is associated with an increased risk of coronary artery disease (CAD) . However, type 2 diabetes (T2DM) and CAD frequently coincide, and the single and joint effects of T2DM and angiographically determined CAD with albuminuria are unclear. This issue therefore was addressed in the present study. We investigated 831 patients with angiographically proven CAD, of whom 261 had T2DM (CAD+/T2DM+) and 570 did not have diabetes (CAD+/T2DM-) and 263 controls without CAD, of whom 63 had T2DM (CAD-/T2DM+) and 200 did not have diabetes (CAD-/T2DM-) . The albumin / creatinine ratio (ACR) was 37±1in CAD-/T2DM- patients. Compared to this group it was higher in CAD-/T2DM+ patients (193±642; p<0,001) , but not in CAD+/T2DM- patients (52±184; p=0,421) , in whom it was significantly lower than in CAD-/T2DM+ patients (p<0.001) . In CAD+/T2DM+ patients the ACR (162±466) was higher than in CAD-/T2DM- (p<0,001) and in CAD+/T2DM- patients (p<0,001) , but did not differ significantly to that in CAD-/T2DM+ patients (p=0,225) . In multivariate analysis of covariance, T2DM but not CAD proved to be an independent predictor of ACR after adjustment for age, sex, body mass index, LDL-C, smoking, hypertension and the use of ACE inhibitors /AT2-antagonists and statins (F=22.06; p<0.0 and F=0.520; p=0.471, respectively) . We conclude that T2DM but not CAD is an independent determinant of albuminuria.