Urine albumin-to-creatinine ratio: A marker of early endothelial dysfunction in youth

Abstract

Context: The urine albumin-to-creatinine ratio (UACR) is a useful predictor of cardiovascular (CV) events in adults. Its relationship to vascular function in children is not clear. Objective: Weinvestigated whether UACR was related to insulin resistance and endothelial function, a marker of subclinical atherosclerosis, in adolescents across the spectrum of glucose regulation. Participants: Participants were 58 adolescents: 13 normal weight (NW), 25 overweight with normal glucose tolerance (OW-NGT), and 20 overweight with prediabetes (OW-PreD). Interventions: Interventions included oral glucose tolerance test, hyperinsulinemic-euglycemic clamp with determination of insulin sensitivity (IS), endothelial function assessment by peripheral arterial tonometry determination of the reactive hyperemia index (RHI), body composition (dualenergy x-ray absorptiometry), and abdominal fat distribution (magnetic resonance imaging). Primary Outcome Measure: Fasting UACR was determined. Results: The 3 groups did not differ with respect to age, sex, or Tanner stage. The NW group had significantly lower percent body fat, higher IS (10.4 ± 0.9, 3.5 ± 0.6, and 2.1 ± 0.2 mg/kg/min per μU/mL; P