A prospective study of microalbuminuria and incident coronary heart disease and its prognostic significance in a British population - The EPIC-Norfolk study
A prospective study of microalbuminuria and incident coronary heart disease and its prognostic significance in a British population - The EPIC-Norfolk study
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DOI：
10.1093/aje/kwh037
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发表时间：
2004-02-01
影响因子：
5
通讯作者：
Wareham, NJ
中科院分区：
文献类型：
--
作者：
Yuyun, MF;Khaw, KT;Wareham, NJ
微量白蛋白尿与糖尿病和高血压患者心血管和肾脏疾病风险增加相关。微量白蛋白尿作为冠心病（CHD）预测因子的作用尚未在大规模人群队列中进行研究，其在确诊CHD患者中的预后意义尚不确定。作者研究了微量白蛋白尿与CHD事件之间的关系（1993-2002），研究对象为22，368名年龄在40-79岁之间的英国人群队列，这些人群没有普遍的基线CHD，并在1，596名基线CHD参与者中评估了其预后意义。参与者是联合王国诺福克欧洲癌症与营养前瞻性调查（EPIC-诺福克研究）的成员。在基线时，参与者被分为正常白蛋白尿、微量白蛋白尿和大量白蛋白尿组。在平均6.4年的随访中，登记了800例原发性CHD事件。按白蛋白尿顺序分类，经年龄调整的CHD发病率显着增加（正常白蛋白尿三分位数分别为4.3、4.4和5.6/1，000人年，微量白蛋白尿为7.1/1，000人年，大量白蛋白尿为12.2/1，000人年;趋势p < 0.001）。对于微量白蛋白尿和大量白蛋白尿，原发性CHD事件的多变量风险比分别为1.36（95%置信区间（CI）：1.12，1.64）和1.59（95% CI：1.10，2.37）。在已确定基线CHD的参与者中，与微量白蛋白尿相关的全因死亡率的独立风险为1.61（95%CI：1.19，2.07）。在一般人群中，微量白蛋白尿可能有助于识别冠心病和随后死亡风险增加的人。
Microalbuminuria is associated with an increased risk of cardiovascular and renal disease in patients with diabetes and hypertension. The role of microalbuminuria as a predictor of coronary heart disease (CHD) has not been examined in large general-population cohorts, and its prognostic significance in persons with established CHD is uncertain. The authors examined the relation between microalbuminuria and incident CHD (1993-2002) in a population-based British cohort of 22,368 men and women aged 40-79 years without prevalent baseline CHD and evaluated its prognostic significance in 1,596 participants with baseline CHD. Participants were members of the Norfolk, United Kingdom, component of the European Prospective Investigation into Cancer and Nutrition (the EPIC-Norfolk Study). At baseline, participants were categorized into normoalbuminuria, microalbuminuria, and macroalbuminuria groups. During an average of 6.4 years of follow-up, 800 primary CHD events were registered. The age-adjusted incidence of CHD increased significantly across ordered categories of albuminuria (4.3, 4.4, and 5.6/1,000 person-years across tertiles of normoalbuminuria, 7.1/1,000 person-years for microalbuminuria, and 12.2/1,000 person-years for macroalbuminuria; p for trend < 0.001). The multivariate hazard ratio for incident primary CHD was 1.36 (95% confidence interval (CI): 1.12, 1.64) for microalbuminuria and 1.59 (95% CI: 1.10, 2.37) for macroalbuminuria. Among participants with established baseline CHD, the independent risk of all-cause mortality associated with microalbuminuria was 1.61 (95% CI: 1.19, 2.07). Microalbuminuria may be useful in identifying persons at increased risk of CHD and subsequent death in the general population.