Objective: Microalbuminuria (MAU) is a marker of early kidney injury
and cardiovascular risk. We assessed the association of MAU with
plasma adiponectin, leptin and hsCRP, as inflammatory markers,
accounting for hypertension, diabetes and obesity.
Design and methods: Population based, cross-sectional study in
Caucasian subjects aged 35 to 75 years in Lausanne, Switzerland.
MAU, measured on spot morning urine, was used either as a
continuous (MAU) or dichotomized variable (MA defined as MAU
>2.5 and >3.5 mg/mmol creatinine in men and women, respectively).
Results: The 2955 women (age 53.3 ± 10.7, mean ± SD years) had
mean body mass index (BMI) 24.9 ± 4.5 kg/m. The 2479 men (age 53.1
± 10.8 years) had mean BMI 27.0 ± 3.9 kg/m². Median hsCRP was
1.3 and 1.3 mg/L, median adiponectin 6.2 and 10.6 mg/mL in men and
women, respectively. MA prevalence was 4.9% in women and 9.8%
in men. In multivariate regression analysis adjusting for potential
confounders (age, sex, hypertension, diabetes, eGFR, BMI, percent
fat mass, insulin and smoking), log-transformed MAU was positively
associated with hsCRP (P <0.001) and adiponectin (P = 0.002), but not
with leptin. The association of adiponectin with MAU was stronger in
subjects with low hsCRP, and vice versa (P interaction <0.001).
Conclusion: Adiponectin and hsCRP are significant positive
determinants of MAU, independently of diabetes, hypertension and fat
mass. A negative interaction between hsCRP and adiponectin was
found for their effect on MAU. Whether hyperadiponectinemia represents
an adequate protective response to vascular stress or has negative
causal impact on the development of MAU should be assessed in
further studies.