Cross-sectional and longitudinal assessments of risk factors associated with hypertension and moderately increased albuminuria comorbidity in patients with type 2 diabetes: a 9-year open cohort study

Abstract

Background: Moderately increased albuminuria (MIA) is strongly associated with hypertension (HTN) in patients with type 2 diabetic mellitus (T2DM). However, the association between risk factors and coexisting HTN and MIA remains unassessed. Objectives: This study aimed to determine both cross-sectional and longitudinal associations of risk factors with HTN and MIA comorbidity in patients with T2DM. Methods: A total of 1,600 patients with T2DM were examined at baseline and longitudinal data were obtained from 1,337 T2DM patients with at least 2 follow-up visits to assess the presence of HTN alone (yes/no), MIA alone (yes/no) and the coexistence of both (yes/no) in a 9-year open cohort study between 2004 and 2013. Bivariate mixed-effects logistic regression with a Bayesian approach was employed to evaluate associations of risk factors with HTN and MIA comorbidity in the longitudinal assessment. Results: After adjustment for age and BMI, patients with uncontrolled plasma glucose, as a combined index of the glucose profile, were more likely to have HTN odds ratio (OR): 1.73 with 95% Bayesian credible intervals (BCI) 1.29-2.20 and MIA OR: 1.34 (95% BCI 1.13-1.62). The risks of having HTN and MIA were increased by a one-year raise in diabetes duration with 0.89 (95% BCI 0.84-0.96) and 0.81 (95% BCI 0.73-0.92) ORs, respectively and a one-unit increase in non-high-density lipoprotein-cholesterol (Non-HDL-C) with 1.30 (95% BCI 1.23-1.34) and 1.24 (95% BCI 1.14-1.33) ORs, respectively. Conclusions: T2DM patients with HTN, MIA, and the coexistence of both had uncontrolled plasma glucose, significantly higher Non-HDL-C, and shorter diabetes duration than the other T2DM patients. Duration of diabetes and uncontrolled plasma glucose index showed the stronger effects on HTN and MIA comorbidity than on each condition separately.