| Title: | Urinary albumin-to-creatinine ratio and incident type 2 diabetes: a 13.8-year cohort study of 411,389 UK biobank participants |
| Journal: | Diabetes Research and Clinical Practice |
| Published: | 16 Apr 2026 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/42000049/ |
| DOI: | https://doi.org/10.1016/j.diabres.2026.113265 |
Publication 17969
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Abstract
AIMS: Microalbuminuria, common in diabetes, lacks clarity as a predictor of diabetes onset. This study examines its association with incident type 2 diabetes (T2DM) and clinical implications.</p>
METHODS: This prospective cohort analysis utilized data from 411,389 UK Biobank participants with baseline urine albumin-to-creatinine ratio (UACR) measurements. Cox proportional hazards regression models, supplemented by restricted cubic spline analyses, were implemented to longitudinally evaluate the association between UACR levels and incident T2DM risk.</p>
RESULTS: Over an average follow-up duration of 13.8 years (range: 13.1-14.6 years), 15,942 new cases of diabetes were identified. After adjusting for potential confounders, the hazard ratios for incident T2DM were 1.31 (95% CI: 1.17-1.45) for UACR between 3-30 mg/mmol and 2.20 (95% CI: 1.58-3.06) for UACR > 30 mg/mmol, when compared to a reference UACR of <3 mg/mmol. These results remained stable across multiple sensitivity analyses, including those addressing potential confounding factors such as body mass index, insulin resistance, uric acid levels, and estimated glomerular filtration rate using the creatinine-cystatin C equation (eGFRcr-cys).</p>
CONCLUSION: This large-scale cohort study demonstrates that microalbuminuria serves as a clinical predictor of elevated risk for incident T2DM in adults. Routine UACR screening in high-risk populations may enhance early detection and intervention.</p>
7 Authors
- Xiu Hong Yang
- Yao Liu
- Jia Xiang Du
- Yi Jun Lu
- Hui Min Jin
- Zhi Bin Ye
- Chen Sheng Fu
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