Age and Ageing Advance Access originally published online on November 14, 2007
Age and Ageing 2008 37(1):77-82; doi:10.1093/ageing/afm148
The association between urinary albumin excretion and ankle-brachial index in elderly Taiwanese patients with type 2 diabetes mellitus
1 Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
2 Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
3 Department of Medical Research and Development, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, Taiwan
4 School of Public Health, Taipei Medical University, Taipei, Taiwan
5 Division of Environmental Health and Occupational Medicine of the National Health Research Institutes, Taipei, Taiwan
6 Department of Rehabilitation, Chang Gung Memorial Hospital, Taoyuan, Taiwan
7 School of Medical Technology, Chang Gung University, Taoyuan, Taiwan
Address correspondence to: Chin-Hsiao Tseng. Tel and Fax: (02)2388-3578. Email: ccktsh{at}ms6.hinet.net
Objective: this study examined the association between urinary albumin/creatinine ratio (ACR) and ankle-brachial index (ABI), or peripheral arterial disease (PAD), in elderly patients with type 2 diabetes mellitus (T2DM).
Methods: a total of 290 (108 men, 182 women) T2DM, aged 
65 (71.6 ± 4.9) years were recruited. PAD was diagnosed by ABI<0.9, and ACR was divided into normoalbuminuria (<30.0 µg/mg), microalbuminuria (30.0 – 299.9 µg/mg), and macroalbuminuria ( 300.0 µg/mg).
Results: patients with PAD (n = 45) had higher ln(ACR) than patients without: 4.48 ± 1.48 versus 3.73 ± 1.39 (P<0.01). For normoalbuminuria (n = 112), microalbuminuria (n = 152), and macroalbuminuria (n = 26), respective PAD prevalence was 8.0, 17.1 and 38.5% (P<0.001). The proportion of normoalbuminuria, microalbuminuria and macroalbuminuria in patients with PAD was 20.0, 57.8 and 22.2%, respectively; and 42.0, 51.4 and 6.5%, respectively, in patients without (P<0.001). Ln(ACR) was inversely correlated with ABI in all patients (
= –0.198, P<0.01) and in separate sexes ( = –0.211 for men and = –0.181 for women). The multivariate-adjusted odds ratios for PAD for every 1 unit increment of ln(ACR) was 1.66 (1.17–2.34); and for microalbuminuria versus normoalbuminuria and macroalbuminuria versus normoalbuminuria were 2.54 (1.05–6.17) and 5.86 (1.76–19.52), respectively.
Conclusions: urinary ACR is not only associated with PAD, it is also significantly correlated with ABI in an inverse pattern in elderly Taiwanese with T2DM.
Keywords: ankle-brachial index, microalbuminuria, peripheral arterial disease, urinary albumin/creatinine ratio, Taiwan, elderly
Received 10 October 2006; accepted in revised form 12 September 2007.