Association of Microalbuminuria with High HbA1C levels in Melanesian Adults with Diabetes of at-least 1 Year Duration. Ian Billy1, Izzard Aglua2. 1. Specialist Physician (MMed, MBBS), Nonga General Hospital. Papua New Guinea. 2. Clinical Research Fellow & Internal Medicine Registrar (MPH, MBBS). Sir Joseph Nombri Memorial-Kundiawa General Hospital. Papua New Guinea. Abstract Background Evidence suggest a potential relationship between high or variable HbA1C levels and presence or rate of change of microalbuminuria. Disruption of the vascular endothelial glycocalyx has been linked to chronic hyperglycemia and microalbuminuria, suggesting a possible shared pathophysiological mechanism. Aim To 1) explore potential association between microalbuminuria and high HbA1C levels in Melanesian adults with diabetes mellitus, and 2) asses predictive value of a high HbA1C reading as an indicator of the presence or progression of microalbuminuria. Method A cross-sectional study on 190 patients with either type 1 or 2 diabetes of at least 1-year duration done at a provincial hospital in Papua New Guinea in 2017. Result A significant [P=0.0221], though weak [R2=0.028 <0.70], correlation between UACR and HbA1C [95% statistical confidence] was observed in univariate regression, which was marginally significant [P=0.056] after controlling for weight, systolic hypertension, duration of diabetes, gender and age in multivariate regression. Conclusion A significant [p=0.022], though weak, correlation between UACR and HbA1C levels was observed, which may support usefulness of HbA1C as a predictor for microalbuminuria and diabetic kidney disease. In settings without microalbuminuria testing, high HbA1c levels can be used as a proxy to indicate presence or progression of microalbuminuria, thus prompting timely interventions to prevent further progression of diabetic nephropathy.

中文翻译：

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患有至少1年糖尿病的美拉尼西亚成年人中微量白蛋白尿与高HbA1C水平的关联。

患有至少1年糖尿病的美拉尼西亚成年人中微量白蛋白尿与高HbA1C水平的关联。伊恩·比利（Ian Billy）1，伊扎德·阿格鲁亚（Izzard Aglua）2。1.翁加综合医院专科医师（MMed，MBBS）。巴布亚新几内亚。2.临床研究研究员和内科注册主任（MPH，MBBS）。约瑟夫·诺姆布里爵士纪念馆-昆迪亚瓦综合医院。巴布亚新几内亚。摘要背景证据表明，高或可变的HbA1C水平与微量白蛋白尿的存在或变化率之间存在潜在的关系。血管内皮糖萼的破坏与慢性高血糖症和微量白蛋白尿有关，提示可能存在共同的病理生理机制。目的1）探索美拉尼西亚成年人糖尿病患者微量白蛋白尿与高HbA1C水平之间的潜在关联，2）评估高HbA1C读数的预测价值，作为微蛋白尿症存在或进展的指标。方法2017年在巴布亚新几内亚的一家省级医院对190名至少持续1年的1型或2型糖尿病患者进行了横断面研究。结果显着[P = 0.0221]，但较弱[R2 = 0.028] <0.70]，在单变量回归中观察到UACR和HbA1C之间的相关性[95％统计置信度]，在通过多元回归控制体重，收缩期高血压，糖尿病持续时间，性别和年龄后，这具有边际意义[P = 0.056]。结论UACR与HbA1C水平之间存在显着的[p = 0.022]相关性，尽管相关性较弱，这可能支持HbA1C可作为微蛋白尿和糖尿病性肾脏疾病的预测指标。