Microalbuminuria Is Independently Associated With Deep or Infratentorial Brain Microbleeds in Hypertensive Adults
Microalbuminuria Is Independently Associated With Deep or Infratentorial Brain Microbleeds in Hypertensive Adults
复制标题
DOI：
10.1038/ajh.2011.254
复制
发表时间：
2012-04-01
影响因子：
3.2
通讯作者：
Sobue, Gen
中科院分区：
文献类型：
--
作者：
Umemura, Toshitaka;Kawamura, Takahiko;Sobue, Gen
背景：梯度回波T2加权磁共振成像(GE-MRI)检测到的脑微出血(BMB)可能与缺血性脑小血管疾病(SVD)和未来出血性卒中风险增加有关。慢性肾脏疾病(CKD)与中风患者骨髓基质细胞的存在有关。然而，在无中风人群中，CKD标志物和BMBS之间的关系尚不清楚。方法：285名无神经症状的高血压患者(平均年龄68.6岁)来自医院的门诊，所有参与者都接受了GE-MRI检查。计算晨点尿的尿白蛋白/肌酐比值(UACR)和估计的血清肾小球滤过率(EGFR)。采用多因素Logistic回归分析，在控制了年龄、性别、抗高血压或抗血栓药物的使用和MRI结果的情况下，评估了这些肾脏生物标志物与骨髓基质细胞的存在和位置的关系。深部或幕下BMBS患者的UACR中位数显著高于单纯大叶BMBS患者(54比17 mg/g肌酐，P=0.04)。EGFR水平与BMBS的位置无显著差异。微量白蛋白尿(UACR>；30-
BACKGROUND Brain microbleeds (BMBs) detected on gradient echo T2*-weighted magnetic resonance imaging (GE-MRI) may be pathophysiologically linked to ischemic cerebral small-vessel disease (SVD) and increased risk of future hemorrhagic stroke. Chronic kidney disease (CKD) has been associated with the presence of BMBs in stroke patients. However, the relationship between CKD markers and BMBs in stroke-free populations is unknown.METHODSTwo hundred and eighty-five hypertensive subjects (mean age 68.6 years) without neurological symptoms were enrolled from a hospital-based outpatient clinic and all participants underwent GE-MRI. We calculated urinary albumin/creatinine ratio (UACR) from morning spot urine and the estimated glomerular filtration rate (eGFR) in serum samples. Multivariate logistic regression analysis was used to evaluate the association between these kidney biomarkers and the presence and location of BMBs, controlling for age, sex, use of antihypertensive or antithrombotic drugs, and MRI findings.RESULTSBMBs were observed in 48(16.8%) patients. Median UACRs were significantly higher in patients with deep or infratentorial BMBs than in patients with pure lobar BMBs (54 vs. 17 mg/g creatinine, P = 0.04). No significant differences were found between eGFR levels and the location of BMBs. Microalbuminuria (UACR >30-