Prevalence and Factors Associated with Elevated Urinary Albumin-to-Creatinine Ratio in Elderly Hypertensive Patients with Type 2 Diabetes Mellitus: A Cross-Sectional Study in a Shanghai Community
Abstract
Background: Hypertension and type 2 diabetes mellitus (T2DM) share complex, interrelated pathophysiological mechanisms that contribute to impaired cardiac and renal function, along with complications such as retinopathy. The urinary albumin-to-creatinine ratio (UACR) is a critical biomarker for early detection of renal dysfunction and serves as a diagnostic indicator for both hypertensive and diabetic nephropathy. This study aimed to assess the prevalence of elevated UACR and identify its determinants among elderly individuals with hypertension and T2DM residing in a Shanghai community.
Methods: A cross-sectional study was conducted from January to December 2023 at Chuansha Huaxia Community Health Service Center. The study included participants aged 60 and above with confirmed diagnoses of both hypertension and T2DM. Clinical and laboratory data were collected, and participants were categorized into elevated or normal UACR groups.
Results: Among 831 individuals, 428 had elevated UACR, while 403 had normal levels. Univariate logistic regression identified age, gender, body mass index (BMI), fasting blood glucose (FBG), triglycerides, and estimated glomerular filtration rate (eGFR) as significant factors (P < 0.05). Multivariate analysis revealed age, gender, and FBG as independent predictors. UACR was positively correlated with age, BMI, glycosuria, and proteinuria. A sharp increase in UACR was observed when FBG, uric acid, blood urea nitrogen, and creatinine surpassed critical thresholds, or when eGFR fell below a key value. Conversely, optimal levels of uric acid and triglycerides were linked to the lowest UACR.
Conclusions: These findings underscore the importance of monitoring metabolic and renal parameters to prevent kidney complications in this high-risk population.
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Copyright (c) 2025 Shao-feng Wang, Hai-ying Zhang, Hao-jun Dai, Jie Gong, Jin-jin Shi, Jing-wen Ling, Rosnani Hashim, Yi-hong Wei
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