Relationship between high‐normal albuminuria and arterial stiffness in Chinese population
Relationship between high‐normal albuminuria and arterial stiffness in Chinese population
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DOI：
10.1111/jch.13979
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发表时间：
2020-08
期刊：
影响因子：
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通讯作者：
Chaoyi Ye;Jin Gong;Tingjun Wang;Li Luo;Guili Lian;Huajun Wang;Weixiao Chen;Liang-di Xie
中科院分区：
文献类型：
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作者：
Chaoyi Ye;Jin Gong;Tingjun Wang;Li Luo;Guili Lian;Huajun Wang;Weixiao Chen;Liang-di Xie
正常高蛋白尿与心血管疾病的发病率和死亡率有关。动脉僵硬度被认为是心血管疾病的预测因子。然而，在中国人群中，正常高蛋白尿与动脉僵硬度之间的关系尚不确定。本研究共纳入1343名中国受试者（年龄58.9 ± 12.1岁，63.53%为男性）。高正常白蛋白尿定义为尿白蛋白与肌酐比值（UACR）高于正常白蛋白尿范围内的中位数。根据UACR水平，将所有参与者分为低正常白蛋白尿组（UACR < 6.36 mg/g，n = 580）、高正常白蛋白尿组（6.36 mg/g ≤ UACR < 30 mg/g，n = 581）、微量白蛋白尿组（30 mg/g ≤ UACR < 300 mg/g，n = 162）和大量白蛋白尿组（UACR ≥ 300 mg/g，n = 20）。通过测量颈动脉-股动脉脉搏波速度（cfPWV）评估动脉僵硬度。随着UACR的增加，cfPWV逐渐升高（P <0.001）。逐步多元回归分析显示，收缩压、年龄、血清肌酐、心率、对数（LG）转换的UACR和空腹血糖与所有受试者的cfPWV独立相关（P < .001）。在高正常白蛋白尿和大量白蛋白尿受试者中，发现LG‐UACR与cfPWV相关。在高正常白蛋白尿受试者中进一步分层后，男性、65岁以上老年人或血压正常者中的相关性仍然存在。总之，在蛋白尿排泄正常高水平的受试者中，UACR与动脉僵硬度相关。正常高蛋白尿可能是动脉僵硬的早期指标，尤其是在中国人群中的男性、老年人或血压正常者中。此外，年龄和血压仍然是动脉硬化的最重要的危险因素。
High‐normal albuminuria is related to the morbidity and mortality of cardiovascular disease. Arterial stiffness has been regarded as a predictor of cardiovascular disease. However, the relationship between high‐normal albuminuria and arterial stiffness is uncertain in Chinese population. A total of 1343 Chinese participants (aged 58.9 ± 12.1 years, 63.53% male) were included in this study. High‐normal albuminuria was defined as urinary albumin‐to‐creatinine ratio (UACR) above the median within normal albuminuria. Based on the level of UACR, all participants were divided into low‐normal albuminuria group (UACR < 6.36 mg/g, n = 580), high‐normal albuminuria group (6.36 mg/g ≤ UACR < 30 mg/g, n = 581), microalbuminuria (30 mg/g ≤ UACR < 300 mg/g, n = 162), and macroalbuminuria (UACR ≥ 300 mg/g, n = 20). Arterial stiffness was assessed by measuring carotid‐femoral pulse wave velocity (cfPWV). With the increment of UACR, the level of cfPWV was increased gradually (P < .001). Stepwise multiple regression analysis showed that systolic blood pressure, age, serum creatinine, heart rate, logarithmic (LG)‐transformed UACR, and fasting plasma glucose were independently associated with cfPWV in all subjects (P < .001). LG‐UACR was found to be related to cfPWV in high‐normal albuminuria and macroalbuminuria subjects. After further stratification in the high‐normal albuminuria subjects, their relation remained in male, elderly over 65 years old, or normotensives. In summary, UACR is associated with arterial stiffness in subjects with proteinuria excretion in high normal level. High‐normal albuminuria might be an early indicator of arterial stiffness, especially in male, elderly, or normotensives in Chinese population. Furthermore, age and blood pressure are still observed to be the most important risk factor of arterial stiffness.