Urine Albumin-to-Creatinine Ratio: A Marker of Early Endothelial Dysfunction in Youth

Context: The urine albumin-to-creatinine ratio (UACR) is a useful predictor of cardiovascular (CV) events in adults. Its relationship to vascular function in children is not clear. Objective: We investigated whether UACR was related to insulin resistance and endothelial function, a marker of subclinical atherosclerosis, in adolescents across the spectrum of glucose regulation. Participants: Participants were 58 adolescents: 13 normal weight (NW), 25 overweight with normal glucose tolerance (OW-NGT), and 20 overweight with prediabetes (OW-PreD). Interventions: Interventions included oral glucose tolerance test, hyperinsulinemic-euglycemic clamp with determination of insulin sensitivity (IS), endothelial function assessment by peripheral arterial tonometry determination of the reactive hyperemia index (RHI), body composition (dual-energy x-ray absorptiometry), and abdominal fat distribution (magnetic resonance imaging). Primary Outcome Measure: Fasting UACR was determined. Results: The 3 groups did not diff...