Evaluation of measures of urinary albumin excretion in epidemiologic studies
Evaluation of measures of urinary albumin excretion in epidemiologic studies
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DOI：
10.1093/aje/kwh326
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发表时间：
2004-12-01
影响因子：
5
通讯作者：
Stamler, J
中科院分区：
文献类型：
--
作者：
Dyer, AR;Greenland, P;Stamler, J
在流行病学研究中，24小时尿白蛋白排泄率(UAE)被认为是确定白蛋白水平的金标准，但这种方法不方便，而且往往无法获得。更简单的替代方法包括从单个样本获得的白蛋白/肌酐比率(ACR)和尿白蛋白浓度(UAC)。作者评估了ACR和UAC作为阿联酋替代品的优势和劣势，方法是对1996-1999年间从4678名年龄在40-59岁的国际常量营养素和血压研究中收集的两个24小时尿样进行白蛋白测量(来自4个国家的17个人口样本)。作者比较了ACR和UAC在与UAE的相关性、日常的人内变异性以及与UAE的已知预测因素的相关性。男性和女性的ACR与阿联酋的等级顺序相关性分别为0.949和0.942，而UAC分别为0.881和0.816。三种测量方法的平均人内变异系数为34.0-40.0%，UAC的变异系数最小。UAE、ACR和UAC与血压的平均相关性相似，但ACR与体重指数的相关性较低(ACR为0.118，UAC为0.188，UAE为0.211)，因为体重指数与肌酐水平高度相关。因此，UAC和ACR是较复杂的阿联酋的可接受替代方案，在某些方面，较简单的UAC可能比ACR更可取。
Twenty-four-hour urinary albumin excretion (UAE) is considered the gold standard for determining albumin level in epidemiologic studies, but this measure is inconvenient and often unavailable. Simpler alternatives include the albumin:creatinine ratio (ACR) and urinary albumin concentration (UAC) obtained from a single sample. The authors assessed the strengths and weaknesses of ACR and UAC as alternatives to UAE using albumin measurements from two 24-hour urine samples collected in 1996-1999 from 4,678 participants aged 40-59 years in the International Study of Macronutrients and Blood Pressure (17 population samples from four countries). The authors compared ACR and UAC with regard to correlations with UAE, daily within-person variability, and associations with known predictors of UAE. Rank-order correlations of ACR with UAE were 0.949 and 0.942 for men and women, respectively, versus 0.881 and 0.816 for UAC. Mean within-person coefficients of variation were 34.0-40.0% for the three measures, with the smallest values being observed for UAC. Average correlations with blood pressure were similar for UAE, ACR, and UAC, but the correlation with body mass index was lower for ACR (0.118 for ACR and 0.188 for UAC vs. 0.211 for UAE) because of high correlation between body mass index and creatinine level. Thus, UAC and ACR are acceptable alternatives to the more complex UAE, and the simpler UAC may be preferable to ACR in some respects.