Moderately increased albuminuria is an independent risk factor of cardiovascular events in the general Japanese population under 75 years of age: the Watari study.
Moderately increased albuminuria is an independent risk factor of cardiovascular events in the general Japanese population under 75 years of age: the Watari study.
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DOI：
10.1371/journal.pone.0123893
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Munakata M
中科院分区：
文献类型：
--
作者：
Konno S;Munakata M
白蛋白尿（以前称为微量白蛋白尿）中度增加被广泛认为是心血管疾病的预测因子。然而，尚不清楚该观察结果是否适用于亚洲人群，因为得出该结论的研究是在西方人群中进行的。本研究的目的是检验这一假设，如果适度增加的白蛋白尿可能是一个独立的预测心血管疾病的死亡率和发病率在日本人口。研究人群包括宫城县瓦塔里的3093名居民，他们在2009年参加了年度健康检查。我们检查了人体测量、坐位血压、空腹血样和尿白蛋白与肌酐比值（UACR）。基线评估后，对受试者进行长达60个月的前瞻性随访。主要心血管事件（卒中、心肌梗死、血运重建和心血管死亡）的发生率根据死亡证明记录或发送至日本国民健康保险的医疗索赔确定。对于那些达到75岁的人，由于他们被转移到不同的医疗保险制度，后续行动被停止。在平均47.8个月的随访期间，我们观察到57起心血管事件。白蛋白尿中度增加（UACR 30-299 mg/gCr）患者的主要心血管事件累积发生率显著高于白蛋白尿正常（UACR <30 mg/gCr）患者（6.4% vs. 2.2%，对数秩检验p = 0.0002）。多变量考克斯比例风险分析显示，白蛋白尿中度增加是心血管事件的独立预测因子（HR 2.386，95% CI：1.120-4.390）。在75岁以下的日本普通人群中，白蛋白尿中度增加是心血管事件的独立预测因子。
Moderately increased albuminuria (formerly called microalbuminuria) is widely recognized as a predictor of cardiovascular disease. However, it is not clear whether this observation is applicable to the Asian population, as studies leading to this conclusion were conducted on Western populations. The aim of this study was to examine the hypothesis if moderately increased albuminuria could be an independent predictor of cardiovascular mortality and morbidity in the Japanese population. The study population consisted of 3093 inhabitants of Watari, Miyagi Prefecture, who participated in an annual health check-up in 2009. We examined anthropometry, sitting blood pressure, fasting blood sample, and urine albumin-to-creatinine ratio (UACR). After baseline assessment, subjects were followed prospectively for up to 60 months. The incidence of major cardiovascular events (stroke, myocardial infarction, revascularization, and cardiovascular death) was determined based on death certificate records or medical claims sent to the National Health Insurance of Japan. Follow-up was discontinued for those who reached 75 years of age because they were moved to a different medical insurance system. We observed 57 cardiovascular events during a mean follow-up period of 47.8 months. The cumulative incidence rate for major cardiovascular events was significantly higher in patients with moderately increased albuminuria (UACR 30–299 mg/gCr) than in those with normoalbuminuria (UACR <30 mg/gCr) (6.4% vs. 2.2%, p = 0.0002 by log-rank test). Multivariate Cox proportional hazards analyses have revealed that moderately increased albuminuria is an independent predictor of cardiovascular events (HR 2.386, 95% CI: 1.120–4.390). Moderately increased albuminuria is an independent predictor of cardiovascular events in the general Japanese population under 75 years of age.
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影响因子：
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