Introduction
The term metabolic Syndrome refers to: abdominal obesity, insulin resistance, hypertension & dyslipidemia (elevated triglyceride and decreased HDL Cholesterol level).1
Microalbuminuria, defined as a urine albumin- creatinine ratio (UACR) of > 2 g/mmol, originally has been used as an early warning sign of chronic kidney disease and diabetic nephropathy by H.C. Gerstein & J.F. Mann.2 Additionally, it has been known as a useful predictor of cardiovascular events in adults.3, 4, 5 Microalbuminuria is considered as an early indicator of chronic renal disorder, vascular dysfunction and cardiovascular mortality.6, 7, 8 Microalbuminuria is more frequent in subjects with type 2 Diabetes8 and has been included in the unifying definition of Metabolic Syndrome (MetS) suggested by WHO.9 In previous studies, microalbuminuria was associated with hypertension and abdominal obesity.10, 11
MetS is a group of metabolic abnormalities characterized by elevated blood pressure, hyperglycemia, abdominal obesity, high triglycerides and reduced high-density lipoprotein cholesterol that collectively increases the risk of diabetes, cardiovascular diseases, and overall mortality.12, 13, 14 The American Heart Association criteria15 did not include microalbuminuria as part of MetS. Several studies have shown association of microalbuminuria with MetS and its components in adults.16, 17, 18
Table 1
|
|
Male |
Female |
|
|
|
|
Parameter |
Mean±SD |
Mean±SD |
T Value |
P Value |
Significant |
|
Age |
55.84±13.52 |
57.56±10.08 |
0.7212 |
0.4725 |
NS(P≥0.05) |
|
HBA1C |
8.564±2.663 |
11.62±12.86 |
2.327 |
0.021 |
S(P≤0.05) |
Table 2
|
|
Male |
Female |
|
|
|
|
Parameter |
Mean±SD |
Mean±SD |
T Value |
P Value |
Significant |
|
Age |
55.84±13.52 |
57.56±10.08 |
0.7212 |
0.4725 |
NS(P≥0.05) |
|
Microalbumin |
371.5±1184 |
60.37±116.6 |
2.7832 |
0.0059 |
S(P≤0.05) |
Table 3
|
|
Raised |
Unraised |
|
|
|
|
Parameter |
Mean±SD |
Mean±SD |
T Value |
P Value |
Significant |
|
HBA1C |
10.42±9.628 |
5.066±0.216 |
5.5595 |
0.0001 |
S(P≤0.05) |
|
Microalbumin |
412.1±1133 |
11.97±7.129 |
3.5315 |
0.0005 |
S(P≤0.05) |
Table 4
|
|
Male |
Female |
|
|
|
|
Parameter |
Mean±SD |
Mean±SD |
T Value |
P Value |
Significant |
|
HBA1C |
8.564±2.663 |
11.62±12.86 |
2.327 |
0.021 |
S(P≤0.05) |
|
Microalbumin |
391.5±1184 |
60.37±116.6 |
2.7832 |
0.0059 |
S(P≤0.05) |
Table 5
|
|
HBA1C |
Microalbumin |
|
|
|
|
Parameter |
Mean±SD |
Mean±SD |
T Value |
P Value |
Significant |
|
Age |
56.7±11.89 |
56.7±11.89 |
0 |
1 |
NS(P≥0.05) |
|
observed value |
12.24±12.88 |
280.5±1043 |
2.5718 |
0.0108 |
S(P≤0.05) |
HbA1c refers to glycated haemoglobin. It develops when haemoglobin, a protein within red blood cells that carries oxygen throughout your body, joins with glucose in the blood becoming glycated. By measuring glycated haemoglobin clinicians are able to get an overall picture of what our average blood sugar levels have been over period of weeks/months. When the body processes sugar, glucose in the blood stream naturally attaches to haemoglobin. The amount of glucose that combines with this protein is directly proportional to the total amount of sugar that is in our system at that time. Because red blood cells in human body is for 8-12 weeks before renewal measuring glycated haemoglobin can reflect average blood glucose levels over that duration providing a useful longer term blood glucose control.
Results
According to this study there is significant correlation of HbA1c and Microalbumin in patients of Metabolic syndrome. When we compared both HbA1c and microalbumin in both males and females then mean and SD came out for HbA1C for males 8.56±2.663 and females were 11.62±12.86 with t value 2.327 and p value 0.021 that states it was significant. And for micoralbumin for male 391.5±1184 & for females 60.37±116.6 t value was 2.7832 and p value was 0.0059 it also states it was significant.
Therefore both the parameters were significant in patients of metabolic syndrome.
Discussion
In this study we found strong positive associations between microalbuminuria and metabolic syndrome in both males and females. These results indicate microalbuminuria may be a component of metabolic syndrome supporting results from other epidemiological studies.19, 20, 21, 22 Hypertension has long been associated with microalbuminuria.19, 20, 23, 24 Increased intraglomerular capillary pressure is thought to cause leakage of albumim.25 Clinically microalbuminuria may be an indicator of early vascular complications of hypertension. Yudkin26 proposed in 1996 that the clustering of risk factors attributed to insulin resistance and microalbuminuria may all be features of damage to different aspects of endothelial functions. Signs of early endothelial dysfunction as manifested by microalbuminuria may herald impending renal impairment and may offer another focus for treatment of metabolic syndrome.
Studies suggest that prevalence of microalbuminuria is greatest in populations with both hypertension and diabetes.27, 28, 29 Microalbuminuria may reflect chronicity of even mild BP and glucose elevations.
Further research in this area could investigate the longitudinal relationship and explre pathways between metabolic syndrome and microalbuminuria.
