Very low levels of microalbuminuria are associated with increased risk of coronary heart disease and death independently of renal function, hypertension, and diabetes
Very low levels of microalbuminuria are associated with increased risk of coronary heart disease and death independently of renal function, hypertension, and diabetes
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DOI：
10.1161/01.cir.0000133312.96477.48
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发表时间：
2004-07-06
期刊：
影响因子：
37.8
通讯作者：
Jensen, JS
中科院分区：
文献类型：
--
作者：
Klausen, K;Borch-Johnsen, K;Jensen, JS
背景-本研究的目的是评估人群中尿白蛋白排泄（微量白蛋白尿）的水平，尿白蛋白排泄与冠心病和死亡风险增加相关。微量白蛋白尿被认为是动脉粥样硬化的危险因素。然而，尿白蛋白排泄的下限尚不清楚。这也是未知的肾功能受损是否混淆association.Methods和结果-在第三哥本哈根市心脏研究在1992年至1994年，2762名男性和女性30至70岁进行了详细的心血管调查计划，包括定时过夜尿样。然后，对参与者进行前瞻性随访，直到1999年关于冠心病，直到2001年关于死亡。在随访期间，追踪了109例冠心病事件和276例死亡。尿白蛋白排泄高于上四分位数，即4.8 mug/min，与冠心病风险增加相关（RR，2.0; 95% CI，1.4 - 3.0; P < 0.001）和死亡（RR，1.9; 95%CI，1.5 - 2.4; P < 0.001）与年龄、性别、肾肌酐清除率、糖尿病、高血压和血脂无关。结论：微量白蛋白尿，定义为尿白蛋白排泄>4.8 mug/min（相当于白天约6.4 mug/min），是冠心病和死亡的一个强有力的独立决定因素。我们的建议是重新定义微量白蛋白尿，并进行干预研究。
Background - The aim of this study was to assess the level of urinary albumin excretion (microalbuminuria), which is associated with increased risk of coronary heart disease and death, in the population. Microalbuminuria has been suggested as an atherosclerotic risk factor. However, the lower cutoff level of urinary albumin excretion is unknown. It is also unknown whether impaired renal function confounds the association.Methods and Results - In the Third Copenhagen City Heart Study in 1992 to 1994, 2762 men and women 30 to 70 years of age underwent a detailed cardiovascular investigation program, including a timed overnight urine sample. The participants were then followed up prospectively by registers until 1999 with respect to coronary heart disease and until 2001 with respect to death. During follow-up, 109 incident cases of coronary heart disease and 276 deaths were traced. A urinary albumin excretion above the upper quartile, ie, 4.8 mug/min, was associated with increased risk of coronary heart disease (RR, 2.0; 95% CI, 1.4 to 3.0; P < 0.001) and death (RR, 1.9; 95% CI, 1.5 to 2.4; P < 0.001) independently of age, sex, renal creatinine clearance, diabetes mellitus, hypertension, and plasma lipids. Lower levels of urinary albumin excretion were not associated with increased risk.Conclusions - Microalbuminuria, defined as urinary albumin excretion >4.8 mug/min (corresponding to approximate to6.4 mug/min during daytime), is a strong and independent determinant of coronary heart disease and death. Our suggestion is to redefine microalbuminuria accordingly and perform intervention studies.