388-P: Reproducibility of Urinary Albumin-to-Creatinine Ratio and Its Association with Prediabetes Risk in Healthy Adults with Parental Type 2 Diabetes

Introduction & Objective: We investigated the reproducibility of consecutive uACR measurements and association with progression to prediabetes among African American (AA) and European American (EA) offspring of parents with T2D.

Methods: Normoglycemic participants in the Pathobiology of Prediabetes in a Biracial Cohort study were followed quarterly for 5.5 years (mean 2.62 years) for the primary outcome of incident prediabetes. Baseline and follow-up assessments included oral glucose tolerance test, anthropometry, uACR, and lipid profile. Baseline and annual uACR data from study participants were analyzed. We then assessed the correlation of baseline and repeated annual uACR measurements and association with incident prediabetes.

Results: Baseline uACR levels from 308 participants (167 AA, 141 EA; mean age 45.1 ± 10.3 yr; BMI 30.4 ± 7.34 kg/m2) ranged from 1-29 mg/g; were similar in AA vs. EA participants (6.40 mg/g ± 4.80 vs. 6.80 ± 5.40 mg/g, P=0.52); and higher in women than men (7.30 mg/g ± 5.30 vs. 4.60 ± 3.90 mg/g, P<0.0001). uACR levels were analyzed for the subsequent year (Year 2, N=170). Baseline uACR values were significantly correlated with Year 2 (rho=0.412, P<0.0001) and Year 3 values (rho=0.241, P=0.0023). The mean change in uACR was 2.69 + 19.49 mg/g (41.1%) (Year 2-Baseline) and 1.11 + 15.1 (17.0%) (Year 3-Baseline). During 5.5 years of follow-up, 104 participants developed prediabetes and 204 maintained normoglycemia. Baseline uACR was significantly associated with the risk of progression to prediabetes (rho=0.186, P=0.0011), as was Year 2 uACR (rho=0.247, P=0.0013).

Conclusions: In our study of normoglycemic, normoalbuminuric adults with parental diabetes, uACR in random urine specimens during three consecutive years were significantly correlated, though individual values varied by 17%-41%. Furthermore, baseline uACR and Year 2 were significantly associated with 5-year progression to prediabetes.