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Introduction: Diabetic nephropathy is the leading causeof End Stage Renal Disease in the world, accounting formore than one third of the cases. Micro albuminuria isa marker of wide spread micro vascular damage in Type 2Diabetes Mellitus and an earliest marker for nephropathy.The correlation between presence of overt proteinuria andproliferative diabetic retinopathy have been demonstrated inboth Type 1 and Type 2 diabetic patients. There is an increasingevidence that micro albuminuria could be used as a marker forearly diabetic retinopathy. However, this relationship has notbeen established in our setting. Hence, we planned to evaluatethe prevalence as well as correlation of micro albuminuria andretinopathy in patients of Type 2 Diabetes Mellitus.Material and Methods: 100 Type 2 diabetic patients willingto participate, were enrolled in the study after due approvalfrom the Institutional Ethical committee. Prevalence of microalbuminuria was checked using Micral test. Body Mass Indexand Glycosylated Hemoglobin were also measured. Patientswere evaluated by direct and indirect ophthalmoscopy to lookfor evidence of retinopathy.Results: 56% patients were male with majority of them(70%) were in the age group of 40-60 years. In 39%patients, duration of diabetes was less that 5 years and equalpercentage of patients had micro albuminuria. 45% patientsshowed signs of diabetic retinopathy, whereas, both microalbuminuria and retinopathy were observed in 32% ofpatients (p <0.001). Compared to overall prevalence of microalbuminuria and retinopathy, patients with age more than50 years showed higher prevalence of 51.61% and 56.45%(p=0.001) respectively. Micro albuminuria (52.45%) anddiabetic retinopathy (57.37%) were more likely with durationof diabetes above 6 years (p=0.001). Other factors whichwere statistically significant were Glycosylated Hemoglobin(HbA1c) more than 7% and Body Mass Index (BMI) >25kg/m2.Conclusion: The study showed that there is significantcorrelation between the presence of micro albuminuria anddiabetic retinopathy. Several factors like increase in age,duration of diabetes, HbA1c levels on admission and bodymass index are associated with increased prevalence of microalbuminuria and diabetic retinopathy
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Objective To evaluate the consistency and diagnosis importance among three assays of Micral-Test strip,DCA 2000 analyzer and radioimmunoassay.Methods A total of 133 random urine samples of patients with diabetes were determined positive or questionable positive by Micral-Test strip,from whom urine samples within 8 hours during the nighttime were also collected.Both the two urine samples were determined by three assays for detection of microalbuminuria.Results(1)The value of Alb and AER determined by radioimmunoassy was significantly lower than that by DCA2000 analyzer,of which the sensitivity and specificity is 100%and 86.2%,?=0.812.(2)According to the reading scales of Micral-Test strip,the area under ROC curve(AUC)of random and 8 h urine samples were 0.900 and 0.934 respectively.(3)The AUC of random ACR and Alb was 0.952 and 0.923.The AUC of 8h urine ACR and Alb were 0.965 and 0.958.Conclusion The diagnosis importance among three assays is all dependable.Micral-Test strip is convenient for screening.ACR cannot substitute for AER as a diagnosis standard.And the value determined by DCA 2000 analyzer is more precise than that of radioimmunoassay.
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It is evident that an elevation of airway albumin excreation rate without clinical proteinuria strongly predicts a later progression on diabetic renal disease. So we studied the correlation between Microalbumin checkly RIA & Micral-Test®. We collected urine between 08:00 h and 08:00 h next day and then checked microalbuminuria by radioimmunoassay method and Micral-Test® The results are as follows: 1. There was significant correlation between microalbuminuria checked by RIA & Micral-Test® 2. There was poor correlation between diabetes duration or HV-A1c and maximal change in albumin excreation rate. 3. So we concluded that Micral-Test® can be used in laboratory instead of RIA.