American Journal of Clinical Nutrition, Vol 67, 50-57, Copyright © 1998 by The American Society for Clinical Nutrition, Inc

ORIGINAL RESEARCH COMMUNICATIONS

Microalbuminuria is positively associated with usual dietary saturated fat intake and negatively associated with usual dietary protein intake in people with insulin-dependent diabetes mellitus

MD Riley and T Dwyer
Menzies Centre for Population Health Research, University of Tasmania, Hobart, Australia. mdr@utas.edu.au

Microalbuminuria has a cumulative incidence of > 30% in persons by 25 y duration of insulin-dependent diabetes mellitus (IDDM) and is a strong predictor of renal disease and mortality. Although improved glycemic control, maintenance of normal blood pressure, and use of angiotensin- converting enzyme inhibitors are important strategies to avoid developing microalbuminuria, dietary macronutrient intake may also play a role. A cross-sectional population-based study of Tasmanian adults with IDDM and no previous diagnosis of microalbuminuria was conducted by measuring usual dietary macronutrient intake with a food-frequency questionnaire and defining microalbuminuria as an average urinary albumin excretion rate between 20 and 200 micrograms albumin/min in at least two of three timed overnight urine collections. After sex, age, duration of diabetes, daily number of insulin injections, body mass index, glycated hemoglobin, serum high-density-lipoprotein cholesterol, frequency of exercise, and smoking status were adjusted for, the adjusted odds ratio for microalbuminuria for the highest quintile of energy-adjusted usual saturated fat intake compared with the lowest quintile was 4.9 (95% CI: 1.2, 20.0; P = 0.03). The adjusted odds ratio for microalbuminuria for the highest quintile of energy-adjusted usual protein intake compared with the lowest quintile was 0.10 (95% CI: 0.02, 0.56; P = 0.01). There was no significant association between microalbuminuria and energy-adjusted carbohydrate intake, energy- adjusted monounsaturated fat intake, or energy-adjusted polyunsaturated fat intake.

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