Use of the albumin/creatinine ratio to detect microalbuminuria: Implications of sex and race
Use of the albumin/creatinine ratio to detect microalbuminuria: Implications of sex and race
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使用白蛋白/肌酐比值检测微量白蛋白尿：性别和种族的影响
DOI：
10.1681/asn.v1341034
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发表时间：
2002-04-01
影响因子：
13.6
通讯作者：
Curhan, G
中科院分区：
文献类型：
--
作者：
Mattix, HJ;Hsu, CY;Curhan, G
用于检测微量白蛋白尿的推荐白蛋白（杯）/肌酐（毫克）比率 (ACR)（30 杯/毫克）并未考虑肌酐排泄的性别或种族差异。在全国代表性的受试者样本中，通过使用在点尿样本中测量的一个 ACR 值（大于或等于 30 微克/毫克）和性别特异性切点（男性大于或等于 17 微克/毫克，女性大于或等于 25 微克/毫克）来检查尿白蛋白和肌酐浓度的分布。男性和女性之间的平均尿白蛋白浓度没有显着差异，但尿肌酐浓度显着较高（P < 0.0001）。与非西班牙裔白人相比，非西班牙裔黑人 (NHB) 和墨西哥裔美国人的尿肌酐浓度显着较高，而 NHB 的尿白蛋白浓度显着较高 (P < 0.0001)，但墨西哥裔美国人则不然。当使用单一 ACR 时，男性微量白蛋白尿的患病率显着低于女性（6.0% vs 9.2%；P < 0.0001），非西班牙裔白人的微量白蛋白尿患病率显着低于 NHB（7.2% vs 10.2%；P < 0.0001）。当使用性别特异性 ACR 切点时，男性和女性之间微量白蛋白尿的患病率没有显着差异。在多变量调整模型中，当使用单一 ACR 阈值时，女性性别（比值比，1.62；95% 置信区间，1.29 至 2.05）和 NHB 种族/民族（比值比，1.34；95% 置信区间，1.12 至 1.61）与微量白蛋白尿独立相关。当使用性别特异性 ACR 时，NHB 种族/民族仍然与微量白蛋白尿显着相关，但性别则不然。使用一个 ACR 值来定义微量白蛋白尿可能会低估肌肉质量较高的受试者（男性）以及可能属于某些种族/族裔群体的成员的微量白蛋白尿。
The recommended albumin (mug)/creatinine (mg) ratio (ACR) (30 mug/mg) to detect microalbuminuria does not account for sex or racial differences in creatinine excretion. In a nationally representative sample of subjects, the distribution of urine albumin and creatinine concentrations was examined by using one ACR value (greater than or equal to30 mug/mg) and sex-specific cut-points (greater than or equal to17 mug/mg in men and greater than or equal to25 mug/mg in women) measured in spot urine specimens. Mean urine albumin concentrations were not significantly different between men and women, but urine creatinine concentrations were significantly higher (P < 0.0001). Compared with non-Hispanic whites, urine creatinine concentrations were significantly higher in non-Hispanic blacks (NHB) and Mexican Americans, whereas urine albumin concentrations were significantly higher in NHB (P < 0.0001) but not Mexican Americans. When a single ACR is used, the prevalence of microalbuminuria was significantly lower among the men compared with women (6.0 versus 9.2%; P < 0.0001) and among non-Hispanic whites compared with NHB (7.2 versus 10.2%; P < 0.0001). No significant difference in-the prevalence of microalbuminuria between men and women was noted when sex-specific ACR cutpoints were used. In the multivariate adjusted model, female sex (odds ratio, 1.62; 95% confidence interval, 1.29 to 2.05) and NHB race/ethnicity (odds ratio, 1.34; 95% confidence interval, 1.12 to 1.61) were independently associated with microalbuminuria when a single ACR threshold was used. When a sex-specific ACR was used, NHB race/ethnicity remained significantly associated with microalbuminuria but sex did not. The use of one ACR value to define microalbuminuria may underestimate microalbuminuria in subjects with higher muscle mass (men) and possibly members of certain racial/ethnic groups.