#1755 Association between glycated hemoglobin and elevated urinary albumin-to-creatinine ratio: a cross-sectional analysis

Abstract Background and Aims Diabetic kidney disease remains a significant global health concern, with microalbuminuria serving as an early marker of kidney damage. The relationship between glycemic control, as measured by glycated hemoglobin (HbA1c), and urinary albumin-to-creatinine ratio (UACR) is crucial for understanding disease progression and optimizing patient care. This study aimed to investigate the correlation between HbA1c levels and elevated UACR (>30 mg/g) in a cohort of patients, while also examining the distribution of albuminuria severity and its relationship with glycemic control. Method A cross-sectional study was conducted on Total patients in study: 78. Elevated albuminuria was defined as UACR >30 mg/g, and diabetes was defined as HbA1c ≥6.5%. UACR values were stratified into three categories: moderately increased (30–300 mg/g), severely increased (300–1000 mg/g), and nephrotic range (>1000 mg/g). Pearson correlation analysis was performed to assess the relationship between HbA1c and UACR in patients with elevated albuminuria. Descriptive statistics were calculated for both parameters, and the distribution of UACR severity was analyzed. Results Among the study population, Patients with UACR > 30 mg/g: 56 (71.8%) demonstrated elevated UACR (>30 mg/g). Notably, Patients with elevated UACR and HbA1c ≥ 6.5%: 51 (91.1%) indicating a high prevalence of diabetes in patients with elevated albuminuria. A significant positive correlation was observed between HbA1c and UACR levels in patients with elevated albuminuria (Correlation coefficient: 0.291 P-value: 0.0295 ). The mean UACR in the elevated group was Mean ± SD: 940.5 ± 1806.9 with a median of Median: 234.0. HbA1c levels in this group showed Mean ± SD: 7.7 ± 1.3% with a median of Median: 7.5%. The severity distribution analysis revealed that among patients with elevated UACR, 32 had moderately increased albuminuria (30–300 mg/g), 13 had severely increased albuminuria (300–1000 mg/g), and 11 presented with nephrotic-range proteinuria (>1000 mg/g). Conclusion This study demonstrates a significant positive correlation between HbA1c levels and elevated UACR, suggesting that poor glycemic control is associated with higher degrees of albuminuria. The high prevalence of diabetes (91.1%) among patients with elevated UACR emphasizes the substantial overlap between these conditions. The distribution of UACR severity highlights that while most patients present with moderate albuminuria, a considerable proportion (42.9%) exhibit severe or nephrotic-range proteinuria, indicating advanced kidney damage. These findings underscore the importance of regular screening for albuminuria in diabetic patients and suggest that optimal glycemic control might play a crucial role in preventing or slowing the progression of kidney damage. Further longitudinal studies are warranted to establish causality and evaluate the impact of glycemic control interventions on UACR progression.