Biomarker As Predictor of Coronary Artery Disease in Metabolic Syndrome: Microalbuminuria

Background: Microalbuminuria is linked with metabolic syndrome, which is a condition in which there is hyperinsulinemia, which indicates insulin resistance in the body and overall obesity, hypertension, lipid disorder and higher rate of renal and cardiovascular morbidity. Microalbuminuria (High UACR) is a very important parameter of kidney dysfunction and metabolic disorder, and it can be established as a biomarker for prediction of cardiovascular risk, because it is not related to other risk factors of CAD. Materials and Methods: In this comparative, cross-sectional study, 200 patients with clinically diagnosed metabolic syndrome (MetS) according to the NCEP ATP III criterion were selected out of which 100 were diagnosed cases of CAD (cases) selected from the CCU of Cardiology department and 100 without CAD (controls) were selected from the OPD of Endocrinology department of our tertiary care NIMS Hospital. For estimating FBS/HbA1c & Lipid Profile, early morning fasting blood sample was collected and for estimation of UACR (Urinary Albumin Creatinine ratio) morning 1st urine sample was collected from the patient and was performed in the Central Biochemistry Laboratory, NIMS Hospital. Results: In our study, the age was higher in the cases (MetS with CAD) than controls (MetS without CAD). The median UACR levels were significantly higher (p<0.05) in the cases group [27.84 (11.5-52.94)] than in controls [17.5 (12.93-25.24)], with the prevalence of microalbuminuria (high UACR) also higher in cases (49%) than in controls (17%). The difference in LDL & TAG levels were slightly more in controls than cases but not significant (p>0.05). The HDL levels were significantly lower in cases than controls (p<0.001). Regression analysis shows that MetS with CAD patients with high UACR have 4.6 times high risk of developing CAD than MetS without CAD patients. Conclusion: From our study, we would like to conclude that Microalbuminuria (high UACR) is a very good predicting biomarker of CAD in MetS patients as well as diagnostic follow-ups and prognosis, which will help in better prevention & management of CAD in MetS patients.