Epidemiological studies of microalbuminuria. The Nord-Trøndelag health study 1995-97 (HUNT2)
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Microalbuminuria (MA), defined as a sub-clinical increase of urine albumine excretion (UAE), was first described in type 1 diabetic individuals who developed diabetic nephropathy. Since then, MA has been launched as a novel cardiovascular (CV) risk maker, not only in diabetic individuals, but also in hypertensive and non-diabetic/non-hypertensive persons. The atherosclerosis might be triggered by injury to the endothelium, caused by CV risk factors like smoking, hyperlipidemia, hypertension and diabetes, leading to endothelial dysfunction, increased oxidative stress and inflammation. The link between MA and CV disease (CVD) seems to be endothelial dysfunction with increased permeability, where MA might be the renal marker for a generalized damage in the vascular system. Another new predictor of CVD is C-reactive protein (CRP), which is a marker of inflammation. The goal of this thesis was to increase our knowledge about the atherosclerosis and its mechanisms, to achieve better understanding about MA, especially in non-diabetic individuals, its association to established CV risk factors and to CRP, its association to hard end-points and its importance as a clinical screening tool in non-diabetic individuals.