Research article - (2004)03, 49 - 54
Physical Activity Alters Urinary Albumin/ Creatinine Ratio in Type 1 Diabetic Patient
Ercan Tuncel, Erdinc Erturk, Canan Ersoy, Sinem Kiyici, Cevdet Duran, Nesrin Kuru, Sazi Imamoglu
Uludag University School of Medicine, Department of Endocrinology, Bursa, Turkey

Erdinc Erturk
✉ Uludag University School of Medicine, Department of Endocrinology, Bursa 16059 Turkey
Email: ererturk@uludag.edu.tr
Received: 09-11-2003 -- Accepted: 11-12-2003
Published (online): 01-03-2004

ABSTRACT

While the best way to identify microalbuminuria is to determine albumin excretion rate (AER) in a 24 h urine sample. Published data have shown that calculation of an albumin/creatinine ratio (ACR) in a spot urine sample has reasonable rate of sensitivity and specificity. We aimed to evaluate the effect of daily exercise on ACR and estimate the best time for the examination of the ACR in a spot urine sample. Sixteen eligible patients with Type 1 diabetes mellitus were asked to perform varying degree of exercise periods. Urinary albumin and creatinine excretion rates during each period were determined. ACR and AER of timed urinary samples were compared with the 24 hour urinary AER. We found significant correlations between timed and 24 hour urinary AER. According to diagnostic performance tests, ACR and AER of timed urine samples were both found to be significantly more sensitive during resting period when compared with mild or moderate active periods. It is concluded that ACR and AER of a timed urine sample are sensitive and specific methods for determining microalbuminuria, while overnight resting samples give the impression of being more diagnostic.

Key words: Microalbuminuria, albumin/creatinine ratio, type 1 diabetes mellitus, exercise, nephropathy

Key Points
  • Timed urine samples can predict microalbuminuria but because of the erroneous urine collections, microalbuminuria measurement should be calculated with creatiniuria measurement.
  • With increasing physical activity during urine collection diagnostic performances of the cut-off values go downhill.
  • For detecting microalbuminuria best results are reached with the early-morning urine samples.








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