ArticleCardiovascular diabetology2023
Elevated urine albumin-to-creatinine ratio increases the risk of new-onset heart failure in patients with type 2 diabetes.
Article in Cardiovascular diabetology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
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Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it, 24 citations in OpenAlex.
- Renal Biomarkers and Prognosis in HFpEF and HFrEF: The Role of Albuminuria and eGFR-A Systematic Review.Medicina (Kaunas, Lithuania) · 2025Pooled it
- Microalbuminuria and mortality in individuals with coronary heart disease: A meta-analysis of a prospective study.Indian heart journalPooled it
- Impact of pulse pressure variability evaluated by visit-to-visit on heart failure events in patients with hypertension: insights from the SPRINT trial.European journal of medical research · 2024Trial
- Lifestyle and Metabolic Health, Low-Grade to Clinically Elevated Albuminuria, and Cardiovascular-Renal Diseases.JACC. Asia · 2026Article
- Sex Differences in the Cardiovascular Significance of Albuminuria in Type 2 Diabetes: A Narrative Review.Journal of clinical medicine · 2026Review
- Diagnostic Tests for Stage B Heart Failure.Current cardiology reports · 2026Review
- Development and Validation of a Machine Learning Model for Incident Heart Failure Prediction in Chronic Kidney Disease: A Multicenter Cohort Study.Journal of the American Heart Association · 2026Article
- Renal Biomarkers as Predictors of Renal Damage in Patients With Type 2 Diabetes.BioMed research international · 2026Article
- TyG index is associated with microalbuminuria in a large population-based study: independent and exploratory interaction analyses.PloS one · 2026Article
- Joint association of urinary albumin-to-creatinine ratio within normal range and triglyceride-glucose index with incident cardiovascular disease: a prospective cohort study.Cardiovascular diabetology · 2025Article
- Urinary Albumin-to-Creatinine Ratio, Cardiovascular Health, and All-Cause Mortality in Hypertension: A Nationwide Cohort Analysis.Journal of clinical hypertension (Greenwich, Conn.) · 2025Article
- Clinical Association of Haptoglobin with Oxidized LDL in Obese Patients with Type 2 Diabetes Mellitus.Nutrients · 2025Article
- Association of serum creatinine-to-albumin ratio with 28-day all-cause mortality in older adults critically ill patients with sepsis: a retrospective analysis of the MIMIC-IV database.BMC geriatrics · 2025Article
- Modern-Day Therapeutics and Ongoing Clinical Trials against Type 2 Diabetes Mellitus: A Narrative Review.Current diabetes reviews · 2025Review
- Type 2 diabetes mediated heart failure: focus on early recognition and clinical strategies.Frontiers in endocrinology · 2025Review
- Association between triglyceride to high-density lipoprotein cholesterol ratio and microalbuminuria in the Chinese population.Scientific reports · 2024Article
- An elevated urinary albumin-to-creatinine ratio increases the risk of incident cardia-cerebrovascular disease in individuals with type 2 diabetes.Diabetology & metabolic syndrome · 2024Article
- Association of the longitudinal trajectory of urinary albumin/creatinine ratio in diabetic patients with adverse cardiac event risk: a retrospective cohort study.Frontiers in endocrinology · 2024Article
- A Novel Approach to Staging and Detection of Colorectal Cancer in Early Stages.Journal of clinical medicine · 2023Article
- Are There Any Pleiotropic Benefits of Vitamin D in Patients With Diabetic Kidney Disease? A Systematic Review of Randomized Controlled Trials.Canadian journal of kidney health and disease · 2023Article
Corrections and comments
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Authors and funding
9 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAlthough albuminuria has been linked to heart failure in the general population, the relationship between urine albumin-to-creatinine ratio (uACR) and heart failure in type 2 diabetes patients is not well understood. We aimed to investigate the relationship between uACR and new-onset heart failure (HF) in type 2 diabetics.
methodsWe included 9287 Chinese participants with type 2 diabetes (T2D) but no heart failure (HF) who were assessed with uACR between 2014 and 2016. The participants were divided into three groups based on their baseline uACR: normal (< 3 mg/mmol), microalbuminuria (3-30 mg/mmol), and macroalbuminuria (≥ 30 mg/mmol). The relationship between uACR and new-onset HF was studied using Cox proportional hazard models and restricted cubic spline. The area under the receiver operating characteristic curve (AUC), net reclassification improvement (NRI), and integrated discrimination improvement (IDI) were used to see if incorporating uACR into existing models could improve performance.
results216 new-onset HF cases (2.33%) were recorded after a median follow-up of 4.05 years. When compared to normal uACR, elevated uACR was associated with a progressively increased risk of new-onset HF, ranging from microalbuminuria (adjusted HR, 2.21; 95% CI 1.59-3.06) to macroalbuminuria (adjusted HR, 6.02; 95% CI 4.11-8.80), and 1 standard deviation (SD) in ln (uACR) (adjusted HR, 1.89; 95% CI 1.68-2.13). The results were consistent across sex, estimated glomerular filtration rate, systolic blood pressure, and glycosylated hemoglobin subgroups. The addition of uACR to established HF risk models improved the HF risk prediction efficacy.
conclusionsIncreasing uACR, even below the normal range, is an independent risk factor for new-onset HF in a type 2 diabetic population. Furthermore, uACR may improve HF risk prediction in community-based T2D patients.
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