Assessment and comparison of microalbuminuria in obese and nonobese children

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Microalbuminuria (MA) is a sign of early kidney impairment, as seen in adults, and recent research supports its presence in children with obesity as well as its potential relationship with cardiometabolic variables. Both adults and children share this well-established pathophysiological theory. Indicated a close connection with the main aspect of fatness, such as IR, through the renal hemodynamic effects of insulin. More scientific consideration must be given to the assessment of primary kidney injury in obese children, given the pathological and prognostic implications of this association in everyday practise (counting an elevated danger of developing long term renal disorder over time). Method case-control study is going to be conducted among the patients of AVBRH hospital. A total of thirty participants with fifteen obese and fifteen non obeses controls were included in this study. Result The expected result of the study can determine the correlation between obesity and microalbuminuria, The value of microalbuminuria is high in obese patients as compared to nonobese patients. Conclusion The risk of problems in obese patients can be predicted using microalbuminuria, which can help lower the overall morbidity and mortality associated with renal function. Complications " } { "@context": "http://schema.org", "@type": "BreadcrumbList", "itemListElement": [ { "@type": "ListItem", "position": "1", "item": { "@id": "https://f1000research.com/", "name": "Home" } }, { "@type": "ListItem", "position": "2", "item": { "@id": "https://f1000research.com/browse/articles", "name": "Browse" } }, { "@type": "ListItem", "position": "3", "item": { "@id": "https://f1000research.com/articles/13-535", "name": "Assessment and comparison of microalbuminuria in obese and nonobese..." } } ] } Home Browse Assessment and comparison of microalbuminuria in obese and nonobese... ALL Metrics - Views Downloads Get PDF Get XML Cite How to cite this article Chavhan MAS and Vagga DA. Assessment and comparison of microalbuminuria in obese and nonobese children [version 1; peer review: awaiting peer review] . F1000Research 2024, 13 :535 ( https://doi.org/10.12688/f1000research.150407.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Study Protocol Assessment and comparison of microalbuminuria in obese and nonobese children [version 1; peer review: awaiting peer review] Mr. Atul Sudhakar Chavhan https://orcid.org/0009-0007-3135-0424 1 , Dr.Anjali Vagga 1 Mr. Atul Sudhakar Chavhan https://orcid.org/0009-0007-3135-0424 1 , Dr.Anjali Vagga 1 PUBLISHED 24 May 2024 Author details Author details 1 Biochemistry, Datta Meghe Institutre of Higher Education and Research, Wardha, Maharashtra, 442001, India Mr. Atul Sudhakar Chavhan Roles: Conceptualization, Resources, Writing – Original Draft Preparation, Writing – Review & Editing Dr.Anjali Vagga Roles: Supervision, Validation, Visualization OPEN PEER REVIEW REVIEWER STATUS AWAITING PEER REVIEW This article is included in the Datta Meghe Institute of Higher Education and Research collection. Abstract Background Fatty liver, metabolic syndrome, and cardiovascular disease are just a few of the well-known cardiometabolic complications associated with childhood obesity. Microalbuminuria (MA) is a sign of early kidney impairment, as seen in adults, and recent research supports its presence in children with obesity as well as its potential relationship with cardiometabolic variables. Both adults and children share this well-established pathophysiological theory. Indicated a close connection with the main aspect of fatness, such as IR, through the renal hemodynamic effects of insulin. More scientific consideration must be given to the assessment of primary kidney injury in obese children, given the pathological and prognostic implications of this association in everyday practise (counting an elevated danger of developing long term renal disorder over time). Method case-control study is going to be conducted among the patients of AVBRH hospital. A total of thirty participants with fifteen obese and fifteen non obeses controls were included in this study. Result The expected result of the study can determine the correlation between obesity and microalbuminuria, The value of microalbuminuria is high in obese patients as compared to nonobese patients. Conclusion The risk of problems in obese patients can be predicted using microalbuminuria, which can help lower the overall morbidity and mortality associated with renal function. Complications READ ALL READ LESS Keywords Microalbuminuria, endothelial dysfunction, glomerular filtration barrier, and glomerular endothelial cell Corresponding Author(s) Mr. Atul Sudhakar Chavhan ( [email protected] ) Close Corresponding author: Mr. Atul Sudhakar Chavhan Competing interests: No competing interests were disclosed. Grant information: The author(s) declared that no grants were involved in supporting this work. Copyright: © 2024 Chavhan MAS and Vagga DA. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Chavhan MAS and Vagga DA. Assessment and comparison of microalbuminuria in obese and nonobese children [version 1; peer review: awaiting peer review] . F1000Research 2024, 13 :535 ( https://doi.org/10.12688/f1000research.150407.1 ) First published: 24 May 2024, 13 :535 ( https://doi.org/10.12688/f1000research.150407.1 ) Latest published: 24 May 2024, 13 :535 ( https://doi.org/10.12688/f1000research.150407.1 ) Introduction Microalbuminuria is an increase in urinary albumin excretion (30–300 mg/day) or the microalbumin/creatinine ratio (30–300 mg/g) in a spot urine sample. 1 Approximately 15–20% of diabetic people have microalbuminuria. 2 Adolescents are more likely than adults to have microalbuminuria. 3 In illnesses linked to lifestyle choices, microalbuminuria raises the risk of dementia, cardiovascular disease, mortality, and renal failure. 4 The metabolic syndrome and microalbuminuria are closely connected. 5 Regardless of the glomerular filtration rate, the availability of ongoing microalbuminuria leads to the existence of chronic kidney disease (CKD). 6 In diabetic individuals, microalbuminuria may also be a sign of the acute phase response. However, it is thought that microalbuminuria results from the acute phase in addition to being an inaccurate marker for sudden conditions like sepsis, trauma, burns, and ischemic injuries like myocardial infarction, it is also said to be a reaction to inflammatory mediators. In this regard, it may offer a more durable and accessible compared to other acute phase characteristics. 7 The prevalence of microalbuminuria among Asian, European, and US populations has been estimated at 5.0, 6.7, and 5.0-7.8%, respectively. 8 Microalbuminuria could be detected in patients with acute stroke. 9 Increased albumin throughput over the glomerular filtration barrier results in microalbuminuria. Hypertension is the primary risk part for microalbuminuria in the common people, which is also related with a 25% prevalence of microalbuminuria. 10 Microalbuminuria is a marker for dysfunctional endothelial cells and a predictor of cardiovascular disease events. 11 Microalbuminuria has received widespread recognition as an independent predictor of renal dysfunction. 12 The future appearance of microalbuminuria in type 1 diabetes is predicted by waist circumference. 13 In primary hypertension, the development of microalbuminuria likely reflects glomerular injury. 14 Microalbuminuria is examined as a primary nonspecific marker of inflammation. 15 Microalbuminuria is a measure of long-term kidney disorder that is also progressing cv morbidity and mortality show the presence of renal target organ damage when it exists in clinical situations including long-term kidney disorder, diabetes, or hypertension (HTN). 16 Although the majority of subclinical atherosclerosis markers were not statistically affected by microalbuminuria, the presence of carotid plaque was substantially correlated with the rising value of microalbuminuria. 17 Higher urine microalbuminuria levels and decreased estimated glomerular filtration rate (egfr) are separate liableness for the development of heart stoppage and death in patients with existing heart failure. 18 Microalbuminuria is the first stage of diabetic nephropathy development, and it can advance to clear proteinuria and eventually last-phase renal disease. 19 Objectives The objective is to evaluate the prevalence of microalbuminuria and its relation to increasing weight. Protocol The study will be conducted among the common children of the Vidarbha district in AVBRH hospital. Between obese children and nonobese children, there should be variations among the microalbuminuria of obese and nonobese children. Methods The following study will be performed in collaboration on behalf of Acharya Vinoba Bhave Rural Hospital (AVBRH), Sawangi (Meghe), Wardha, in the Biochemistry division of the Department of Biochemistry, Jawaharlal Nehru Medical College (JNMC), Sawangi (Meghe), from 07 feb 2023 to 2024. If the Committee of Institutional Ethics approves the study and the patients agree, written consent form is taken from the patients for the study then the research will proceed. Sample collection Collection of urine samples • Urine samples must be collected carefully for this examination. • Albumin excretion rate (AER), the gold standard for urine collection, must be accurately timed to be determined. • When this is not achievable, however, determining the Early morning urine (EMU) or random urine samples with low albumin/high creatinine ratio (ACR) are alternate options that can be employed for MA detection. • Normal values for this ratio are less than 30 between albumin (mcg/L) and creatinine (mg/L). • A ratio between 30 and 300 is referred to as microalbuminuria, whereas macroalbuminuria is defined as a ratio more than 300. • On a standard urine dipstick, protein can be detected down to 10–20 mg/dl. • All process is carried out in the central clinical lab in AVBRH in biochemistry in Vitros 5600. • The methods for the parameters are • Albumin:-Bromocresol Green Dye Method • Creatinin:-Enzymatic Creatinine Amidohydrolase Method. Study design This study will be cross-analytical Study settings The following study will be performed in Acharya Vinoba Bhave Rural Hospital (AVBRH), Sawangi (Meghe), Wardha. Inclusion criteria Microalbuminuria compared to non-obese inclusion criteria is the patients of both genders with ages less than 18 years. Exclusion criteria Exclusion criteria were diabetes, patients with hepatic or renal dysfunction, severe chronic disease, and cancerous Disorders, and heart disease with PCOS would have a higher frequency of albuminuria. Bias For proper bias or to manage bias at all levels all necessary measures will be taken. SAMPLE SIZE CALCULATION For Qualitative Variable – Formula Sample size = Z 1 − α / 2 2 p ( 1 − p ) d 2 Z 1-α/2 = Standard normal variate (at 5% type 1 error (P < 0.05) it is 1.96). p = Expected proportion in population based on previous or pilot studies. d = Absolute error or precision. Z 1-α/2 = 1.96 p = 2% = 2/100 = 0.02 d = 5% = 5/100 = 0.05 So, Calculation: Sample size ( N ) = ( 1.96 ) 2 × ( 0.02 ) × ( 1 − 0.02 ) ( 0.05 ) 2 = 3.8416 × 0.02 × 0.98 ( 0.05 ) 2 = 3.8416 × 0.0196 0.0025 = 0.07529536 0.0025 N = 30.11 So the minimum sample size required to conduct this study will be 30 participants. Study reference: Heeyon Cho Formula reference: Daniel et al. Study status The study is currently ongoing with sample collection and is expected to be completed before October 2024. Expected outcomes The study group will be comprised of 30 patients, among which 15 will be obese and 15 will be non obese A normal microalbuminuria value is 30-300 mg/day, and over this, the patients will be associated with microalbuminuria. Discussion In the study of Iroro Enameguolo Yarhere, on Children with type 1 diabetes mellitus, he concluded that protein can be detected down to 10–20 mg/dl on a standard urine dipstick. Children who have type 1 diabetes and who avoid regular gain to insulin are expected to have the development of chronic renal problems earlier which manifest as microalbuminuria. Children with type 1 diabetes who avoid regularly gaining insulin are likely to have the development of life-chronic renal problems earlier and manifest as microalbuminuria. It is important to make sure that these kids don’t continue to suffer from their deficiency, and the healthcare system will do everything it can to make sure that these kids get insulin regularly. 20 Byung Ok Kwak studied Microalbuminuria in children with urinary tract infections. They looked into how factors like age, height, weight, blood pressure, glomerular filtration rate (GFR), and gender correlated with the ratio of children with autism renal scar, hematuria, vesicoureteral reflux, renal parenchymal abnormality, and their propensity to cause UTI problems the judgment is that: In comparison to healthy children, children with UTI had significantly higher spot urine microalbumin/creatinine ratios, which were positively coordinate with GFR. This ratio may be used as a predictive and prescreening indicator in UTI patients. The predictability of microalbuminuria in pediatric UTI patients has to be further investigated. 1 The study Martin Majlund Mikkelsen on Microalbuminuria and short-term prognosis in patients undergoing cardiac surgery was studied to determine if patients undergoing elective cardiothoracic surgery have a higher risk of negative outcomes if they had preoperative microalbuminuria (MA). They concluded that the presence of MA before surgery in patients having elective cardiothoracic surgery was not related to a wide variety of prior postoperative results and that including MA details would not enhance the perfection of the additive euro score. They concluded that the early postoperative outcomes of patients having elective cardiothoracic surgery were not significantly correlated with the preoperative presence of MA, and including details on MA will not enhance the perfection of the additive euro score. They observed that there was no association between the existence of MA before surgery in patients receiving elective cardiothoracic surgery and a wide range of early postoperative outcomes. 5 Ian H. De Boer studied Central Obesity, Incident Microalbuminuria, And Change in Creatinine Clearance in the Epidemiology of Diabetes Interventions and Complications they concluded that the emergence of microalbuminuria in type 1 diabetes is predicted by waist circumference. 13 The study of Alex Chang on lifestyle-related factors, obesity, and incident Microalbuminuria concluded that obesity and eating a poor diet are linked to the incidence of microalbuminuria. 6 N Mahmud studied Microalbuminuria in inflammatory bowel disease he concluded that all individuals with active inflammatory bowel disease have abnormally high levels of microalbuminuria, and the levels decrease when the condition is dormant. Microalbuminuria, which is most likely the result of a quick condition response, offers a quick, easy, and affordable test that may be used to track the progression of inflammatory bowel disease and how well it is responding to treatment. 7 Implication of study The prevalence of microalbuminuria appears to be higher in healthy pediatric patients than in adolescents. Diabetes and metabolic syndrome are known risky conditions for obesity. A higher prevalence of microalbuminuria is not present in obese children without diabetes, though. Cardiovascular risk factors are not linked to microalbuminuria in children who are not diabetic or obese. In contrast, Microalbuminuria is closely correlated with cardiovascular risk factors in obese children, including impaired fasting glucose, insulin resistance, and hypertension. This demonstrates how being overweight significantly alters the connection between microalbuminuria and cardiovascular risk factors. Study limitation: Our study has a smaller sample size. Ethical approval and consent Approved by the Institutional Ethics Committee Datta Meghe Institute of Higher Education and Research Ref. No. DMIHER (DU)/IEC/2023/613 dated on 06/02/2023. Written consent form is taken from the patients for the study then the research will proceed. Data availability There is no association of data with this article. Extended data Figshare: Strobe checklist for assessment and comparison of microalbuminuria in obese and non obese children. https://doi.org/10.6084/m9.figshare.25752198.v1 . 21 Data are available under the terms of the Creative Commons Attribution license (CC BY 4.0). References 1. Kwak BO, Chung S, Kim KS: Microalbuminuria in children with urinary tract infection. Korean J. Pediatr. 2010 Sep; 53 (9): 840–844. PubMed Abstract | Publisher Full Text | Free Full Text 2. Deckert T, Kofoed-Enevoldsen A, Nørgaard K, et al. : Microalbuminuria. Implications for micro- and macrovascular disease. Diabetes Care. 1992 Sep; 15 (9): 1181–1191. PubMed Abstract | Publisher Full Text 3. Cizmecioğlu FM, Noyes K, Bath L, et al. : Audit of microalbumin excretion in children with type I diabetes. J. Clin. Res. Pediatr. Endocrinol. 2009; 1 (3): 136–143. PubMed Abstract | Publisher Full Text 4. Ogi M, Seto T, Wakabayashi Y: A comparison of the utility of the urine dipstick and urine protein-to-creatinine ratio for predicting microalbuminuria in patients with non-diabetic lifestyle-related diseases a comparison with diabetes. BMC Nephrol. 2022 Nov 24; 23 (1): 377. PubMed Abstract | Publisher Full Text | Free Full Text 5. Mikkelsen MM, Andersen NH, Christensen TD, et al. : Microalbuminuria and short-term prognosis in patients undergoing cardiac surgery. Interact. Cardiovasc. Thorac. Surg. 2009 Sep; 9 (3): 484–490. PubMed Abstract | Publisher Full Text 6. Chang A, Van Horn L, Jacobs DR, et al. : Lifestyle-related factors, obesity, and incident microalbuminuria: the CARDIA (Coronary Artery Risk Development in Young Adults) study. Am. J. Kidney Dis. 2013 Aug; 62 (2): 267–275. PubMed Abstract | Publisher Full Text | Free Full Text 7. Mahmud N, Stinson J, O’Connell MA, et al. : Microalbuminuria in inflammatory bowel disease. Gut. 1994 Nov; 35 (11): 1599–1604. PubMed Abstract | Publisher Full Text | Free Full Text 8. Gaeini Z, Bahadoran Z, Mirmiran P, et al. : Spot urinary microalbumin concentration, metabolic syndrome and type 2 diabetes: Tehran lipid and glucose study. BMC Endocr. Disord. 2022 Mar 8; 22 (1): 59. PubMed Abstract | Publisher Full Text | Free Full Text 9. Li F, Chen QX, Peng B, et al. : Microalbuminuria in patients with acute ischemic stroke. Neurol. Res. 2019 Jun; 41 (6): 498–503. PubMed Abstract | Publisher Full Text 10. Satchell SC, Tooke JE: What is the mechanism of microalbuminuria in diabetes: a role for the glomerular endothelium? Diabetologia. 2008 May; 51 (5): 714–725. PubMed Abstract | Publisher Full Text | Free Full Text 11. Yun L, Xu R, Zhang L, et al. : The role of microalbuminuria in arterial endothelial dysfunction in hypertensive patients with carotid plaques. Int. Heart J. 2014; 55 (2): 153–159. PubMed Abstract | Publisher Full Text 12. Colasante AM, Bartiromo M, Nardolillo M, et al. : The tangled relationship between insulin resistance and microalbuminuria in children with obesity. World J. Clin. Pediatr. 2022 Nov 9; 11 (6): 455–462. PubMed Abstract | Publisher Full Text | Free Full Text 13. de Boer IH , Sibley SD, Kestenbaum B, et al. : Central obesity, incident microalbuminuria, and change in creatinine clearance in the epidemiology of diabetes interventions and complications study. J. Am. Soc. Nephrol. 2007 Jan; 18 (1): 235–243. PubMed Abstract | Publisher Full Text | Free Full Text 14. Flynn JT: Microalbuminuria in Children With Primary Hypertension. J. Clin. Hypertens. (Greenwich). 2016 Oct; 18 (10): 962–965. PubMed Abstract | Publisher Full Text | Free Full Text 15. Akbas B, Ozdemir AA, Arslankoylu AE: Does Microalbuminuria Predict Mortality in Pediatric Intensive Care Unit? J. Pediatr. Intensive Care. 2022 Dec; 11 (4): 316–320. PubMed Abstract | Publisher Full Text 16. Márquez DF, Ruiz-Hurtado G, Segura J, et al. : Microalbuminuria and cardiorenal risk: old and new evidence in different populations. F1000Res. 2019; 8 . F1000 Faculty Rev-1659. PubMed Abstract | Publisher Full Text | Free Full Text 17. Szabóová E, Lisovszki A, Fatľová E, et al. : Prevalence of Microalbuminuria and Its Association with Subclinical Carotid Atherosclerosis in Middle Aged, Nondiabetic, Low to Moderate Cardiovascular Risk Individuals with or without Hypertension. Diagnostics (Basel). 2021 Sep 19; 11 (9): 1716. PubMed Abstract | Publisher Full Text | Free Full Text 18. Nakashima K, Kumakura H, Funada R, et al. : Influence of Microalbuminuria on Long-Term Survival and Cardiovascular or Limb Events in Peripheral Arterial Disease. Ann. Vasc. Dis. 2021 Sep 25; 14 (3): 236–243. PubMed Abstract | Publisher Full Text | Free Full Text 19. Ramaphane T, Gezmu AM, Tefera E, et al. : Prevalence and Factors Associated with Microalbuminuria in Pediatric Patients with Type 1 Diabetes Mellitus at a Large Tertiary-Level Hospital in Botswana. Diabetes Metab. Syndr. Obes. 2021; 14 : 4415–4422. PubMed Abstract | Publisher Full Text | Free Full Text 20. Yarhere IE, Jaja T, Anolue M: Microalbuminuria in type 1 diabetes mellitus children in University of Port Harcourt Teaching Hospital, Nigeria. Pan Afr. Med. J. 2020; 36 : 161. 21. Chavhan A: Strobe checklist for assessment and comparison of microalbuminuria in obese and non obese children. figshare. Online resource. 2024. Publisher Full Text Comments on this article Comments (0) Version 1 VERSION 1 PUBLISHED 24 May 2024 ADD YOUR COMMENT Comment Author details Author details 1 Biochemistry, Datta Meghe Institutre of Higher Education and Research, Wardha, Maharashtra, 442001, India Mr. Atul Sudhakar Chavhan Roles: Conceptualization, Resources, Writing – Original Draft Preparation, Writing – Review & Editing Dr.Anjali Vagga Roles: Supervision, Validation, Visualization Competing interests No competing interests were disclosed. Grant information The author(s) declared that no grants were involved in supporting this work. Article Versions (1) version 1 Published: 24 May 2024, 13:535 https://doi.org/10.12688/f1000research.150407.1 Copyright © 2024 Chavhan MAS and Vagga DA. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 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