Sex-specific correlates of microalbuminuria in high-risk adults: a cross-sectional study

Abstract

BACKGROUND: Microalbuminuria is a well-established marker for incipient renal dysfunction and systemic vasculopathy, yet sex-specific determinants in high-risk populations remain incompletely characterized. The objective was to identify sex-specific factors associated with microalbuminuria among adults with high-risk conditions (hypertension, diabetes, or HIV). RESULTS: The study population comprised 92 males and 214 females with comparable age distributions (median 47 vs. 45 years, p = 0.596). Males had significantly higher estimated glomerular filtration rate (eGFR) (110 vs. 104 mL/min/1.73 m², p = 0.026) and lower body mass index (24.1 vs. 27.0 kg/m², p < 0.001). Multivariate analysis confirmed high-sensitivity C-reactive protein as factors that remained associated with microalbuminuria in males, which should be considered exploratory (OR 1.27, 95% CI 1.02–1.58, p = 0.034), while HIV status (OR 2.44, 95% CI 1.06–5.59, p = 0.036) and systolic blood pressure (OR 1.02, 95% CI 1.00-1.04, p = 0.037) remained significant in females. Therefore, this exploratory analysis suggests distinct sex-specific patterns in factors associated with microalbuminuria, with inflammatory markers predominating in males, while HIV and blood pressure factors were more relevant in females. These hypothesis‑generating findings underscore the importance of sex-tailored approaches for early detection and management of renal impairment in high-risk populations.