Cross-sectional associations of albuminuria and C-reactive protein with functional disability in older adults with diabetes

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Abstract

OBJECTIVE - To examine the relationship between albuminuria, inflammation, and disability in older adults with diabetes. RESEARCH DESIGN AND METHODS - Data were from 1,729 adults (≥60 years) with diabetes in the National Health and Nutrition Examination Survey, 1999-2008. Disability in activities of daily living (ADL), instrumental activities of daily living (IADL), leisure and social activities (LSA), general physical activities (GPA), and lower-extremity mobility (LEM) was obtained from self-reports. Urinary albumin-to-creatinine ratio (UACR) (mg/g) was categorized into normal (UACR <30 mg/g), microalbuminuria (UACR 30-300 mg/g), and macroalbuminuria (UACR >300 mg/g). C-reactive protein (CRP) levels were quantified by latex-enhanced nephelometry. RESULTS - In the full-adjusted model, microalbuminuria was associated with disability in ADL, LSA, and LEM with corresponding odds ratios (ORs) (95% CIs) of 1.51 (1.16-1.98), 1.62 (1.23-2.14), and 1.34 (1.03-1.74), respectively, compared with participants without albuminuria. Macroalbuminuria was associated with disability in ADL, IADL, and LEM with corresponding ORs (95% CIs) of 1.94 (1.24-3.03), 1.93 (1.23-3.02), and 2.20 (1.38-3.49), respectively, compared with participants without albuminuria. Elevated CRP (>0.3 mg/dL) was associated with increased odds of disability in ADL and LEM, with corresponding ORs (95% CIs) of 1.28 (1.00-1.62) and 1.68 (1.34-2.11), respectively. Subjects with both albuminuria and elevated CRP had higher odds of disability than individuals with no albuminuria and normal CRP. CONCLUSIONS - Albuminuria and inflammation were independent correlates for disability among older adults with diabetes. There was an interaction of albuminuria and elevated CRP on disability, suggesting that the presence of subclinical inflammation may amplify the effect of albuminuria on disability in older adults living with diabetes.

Original languageEnglish (US)
Pages (from-to)710-717
Number of pages8
JournalDiabetes Care
Volume34
Issue number3
DOIs
StatePublished - Mar 2011

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Albuminuria
Activities of Daily Living
C-Reactive Protein
Lower Extremity
Odds Ratio
Leisure Activities
Inflammation
Albumins
Creatinine
Nephelometry and Turbidimetry
Nutrition Surveys
Latex
Self Report
Research Design

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

Cite this

@article{308f9e59ff97460fbf52ee2e278ca889,
title = "Cross-sectional associations of albuminuria and C-reactive protein with functional disability in older adults with diabetes",
abstract = "OBJECTIVE - To examine the relationship between albuminuria, inflammation, and disability in older adults with diabetes. RESEARCH DESIGN AND METHODS - Data were from 1,729 adults (≥60 years) with diabetes in the National Health and Nutrition Examination Survey, 1999-2008. Disability in activities of daily living (ADL), instrumental activities of daily living (IADL), leisure and social activities (LSA), general physical activities (GPA), and lower-extremity mobility (LEM) was obtained from self-reports. Urinary albumin-to-creatinine ratio (UACR) (mg/g) was categorized into normal (UACR <30 mg/g), microalbuminuria (UACR 30-300 mg/g), and macroalbuminuria (UACR >300 mg/g). C-reactive protein (CRP) levels were quantified by latex-enhanced nephelometry. RESULTS - In the full-adjusted model, microalbuminuria was associated with disability in ADL, LSA, and LEM with corresponding odds ratios (ORs) (95{\%} CIs) of 1.51 (1.16-1.98), 1.62 (1.23-2.14), and 1.34 (1.03-1.74), respectively, compared with participants without albuminuria. Macroalbuminuria was associated with disability in ADL, IADL, and LEM with corresponding ORs (95{\%} CIs) of 1.94 (1.24-3.03), 1.93 (1.23-3.02), and 2.20 (1.38-3.49), respectively, compared with participants without albuminuria. Elevated CRP (>0.3 mg/dL) was associated with increased odds of disability in ADL and LEM, with corresponding ORs (95{\%} CIs) of 1.28 (1.00-1.62) and 1.68 (1.34-2.11), respectively. Subjects with both albuminuria and elevated CRP had higher odds of disability than individuals with no albuminuria and normal CRP. CONCLUSIONS - Albuminuria and inflammation were independent correlates for disability among older adults with diabetes. There was an interaction of albuminuria and elevated CRP on disability, suggesting that the presence of subclinical inflammation may amplify the effect of albuminuria on disability in older adults living with diabetes.",
author = "Kuo, {Hsu Ko} and {Al Snih al snih}, Soham and Kuo, {Yong Fang} and Mukaila Raji",
year = "2011",
month = "3",
doi = "10.2337/dc10-1977",
language = "English (US)",
volume = "34",
pages = "710--717",
journal = "Diabetes Care",
issn = "1935-5548",
publisher = "American Diabetes Association Inc.",
number = "3",

}

TY - JOUR

T1 - Cross-sectional associations of albuminuria and C-reactive protein with functional disability in older adults with diabetes

AU - Kuo, Hsu Ko

AU - Al Snih al snih, Soham

AU - Kuo, Yong Fang

AU - Raji, Mukaila

PY - 2011/3

Y1 - 2011/3

N2 - OBJECTIVE - To examine the relationship between albuminuria, inflammation, and disability in older adults with diabetes. RESEARCH DESIGN AND METHODS - Data were from 1,729 adults (≥60 years) with diabetes in the National Health and Nutrition Examination Survey, 1999-2008. Disability in activities of daily living (ADL), instrumental activities of daily living (IADL), leisure and social activities (LSA), general physical activities (GPA), and lower-extremity mobility (LEM) was obtained from self-reports. Urinary albumin-to-creatinine ratio (UACR) (mg/g) was categorized into normal (UACR <30 mg/g), microalbuminuria (UACR 30-300 mg/g), and macroalbuminuria (UACR >300 mg/g). C-reactive protein (CRP) levels were quantified by latex-enhanced nephelometry. RESULTS - In the full-adjusted model, microalbuminuria was associated with disability in ADL, LSA, and LEM with corresponding odds ratios (ORs) (95% CIs) of 1.51 (1.16-1.98), 1.62 (1.23-2.14), and 1.34 (1.03-1.74), respectively, compared with participants without albuminuria. Macroalbuminuria was associated with disability in ADL, IADL, and LEM with corresponding ORs (95% CIs) of 1.94 (1.24-3.03), 1.93 (1.23-3.02), and 2.20 (1.38-3.49), respectively, compared with participants without albuminuria. Elevated CRP (>0.3 mg/dL) was associated with increased odds of disability in ADL and LEM, with corresponding ORs (95% CIs) of 1.28 (1.00-1.62) and 1.68 (1.34-2.11), respectively. Subjects with both albuminuria and elevated CRP had higher odds of disability than individuals with no albuminuria and normal CRP. CONCLUSIONS - Albuminuria and inflammation were independent correlates for disability among older adults with diabetes. There was an interaction of albuminuria and elevated CRP on disability, suggesting that the presence of subclinical inflammation may amplify the effect of albuminuria on disability in older adults living with diabetes.

AB - OBJECTIVE - To examine the relationship between albuminuria, inflammation, and disability in older adults with diabetes. RESEARCH DESIGN AND METHODS - Data were from 1,729 adults (≥60 years) with diabetes in the National Health and Nutrition Examination Survey, 1999-2008. Disability in activities of daily living (ADL), instrumental activities of daily living (IADL), leisure and social activities (LSA), general physical activities (GPA), and lower-extremity mobility (LEM) was obtained from self-reports. Urinary albumin-to-creatinine ratio (UACR) (mg/g) was categorized into normal (UACR <30 mg/g), microalbuminuria (UACR 30-300 mg/g), and macroalbuminuria (UACR >300 mg/g). C-reactive protein (CRP) levels were quantified by latex-enhanced nephelometry. RESULTS - In the full-adjusted model, microalbuminuria was associated with disability in ADL, LSA, and LEM with corresponding odds ratios (ORs) (95% CIs) of 1.51 (1.16-1.98), 1.62 (1.23-2.14), and 1.34 (1.03-1.74), respectively, compared with participants without albuminuria. Macroalbuminuria was associated with disability in ADL, IADL, and LEM with corresponding ORs (95% CIs) of 1.94 (1.24-3.03), 1.93 (1.23-3.02), and 2.20 (1.38-3.49), respectively, compared with participants without albuminuria. Elevated CRP (>0.3 mg/dL) was associated with increased odds of disability in ADL and LEM, with corresponding ORs (95% CIs) of 1.28 (1.00-1.62) and 1.68 (1.34-2.11), respectively. Subjects with both albuminuria and elevated CRP had higher odds of disability than individuals with no albuminuria and normal CRP. CONCLUSIONS - Albuminuria and inflammation were independent correlates for disability among older adults with diabetes. There was an interaction of albuminuria and elevated CRP on disability, suggesting that the presence of subclinical inflammation may amplify the effect of albuminuria on disability in older adults living with diabetes.

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U2 - 10.2337/dc10-1977

DO - 10.2337/dc10-1977

M3 - Article

VL - 34

SP - 710

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JO - Diabetes Care

JF - Diabetes Care

SN - 1935-5548

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