SAT-582 Urine Albumin-Creatinine Ratio Variability and Carotid Atherosclerosis in Patients with Type 2 Diabetes: A Longitudinal Cohort Study

Abstract Disclosure: J. Moon: None. M. Kim: None. Y. Cho: None. C. Jung: None. W. Lee: None. Background: Albuminuria, defined as excessive urinary albumin excretion, serves as a recognized indicator of elevated atherosclerotic risk, particularly among individuals with diabetes. Despite its clinical relevance, the implications of variability in albuminuria have not been thoroughly investigated. This study sought to elucidate the association between albuminuria variability and the progression of carotid artery atherosclerosis in patients with type 2 diabetes mellitus. Methods: This single-center, retrospective cohort study in Korea analyzed data from 5893 patients with type 2 diabetes who underwent their first carotid artery sonography from 2011 to 2015 and who had at least a 5-year interval between their first and last sonography. Patients were included if they had more than 20 urine albumin-to-creatinine ratio (UACR) measurements between the first and last sonography, and a total of 523 patients were included in the final analysis. Albuminuria variability was calculated using the coefficient of variation (CV) of UACR. Multivariate linear regression was applied to assess the association between albuminuria variability and yearly intima-media thickness (IMT) progression rate. Results: Among 523 patients, 329 (62.9%) were male and 194 (37.1%) were female. The median duration of diabetes was 7.2 years at baseline. Over a median follow-up of 8.5 years, the median number of UACR measurements was 23 (IQR 21-26). Median UACR CV was 70.95% (IQR 52.55-96.42), and median IMT progression rate was 7.510×10-8mm/year. UACR CV was positively associated with yearly IMT progression rate after adjusting for various confounding variables including age, sex, body mass index, blood pressure, baseline UACR, and duration of diabetes. (β=1.708×10-10, p<0.05). Conclusion: This study suggests that long-term albuminuria variability is positively associated with carotid artery atherosclerosis progression in type 2 diabetes patients. Presentation: Saturday, July 12, 2025