Urinary Uromodulin and Risk of Urinary Tract Infections: The Cardiovascular Health Study
Urinary Uromodulin and Risk of Urinary Tract Infections: The Cardiovascular Health Study
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DOI：
10.1053/j.ajkd.2016.08.022
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发表时间：
2017-06-01
影响因子：
13.2
通讯作者：
Sarnak, Mark J.
中科院分区：
文献类型：
--
作者：
Garimella, Pranav S.;Bartz, Traci M.;Sarnak, Mark J.
背景：实验室研究表明，尿调蛋白是健康成年人尿液中最常见的蛋白质，可以预防尿路感染(UTI)。研究设计：前瞻性纵向队列研究。背景和参与者：心血管健康研究中登记的953名参与者。预测者：在现场尿样中用酶联免疫吸附分析法检测尿调蛋白。结果：门诊UTI事件或UTI相关住院事件的合成，并使用国际疾病分类第九版(ICD-9)编码单独识别，使用负二项回归，经年龄、种族、性别、体重指数、糖尿病、估计的肾小球滤过率、尿白蛋白和尿肌酸排泄调整后的稳健标准误差。结果：尿调蛋白水平中位数为25.9(IQR，尿白蛋白和尿肌酐17.3~38.9)微克/毫升，受试者平均年龄78岁，女性占61%，黑人占15%。在186名参与者中，有331例门诊UTI事件和87例与UTI相关的住院治疗，平均随访时间为9.9年。尿调蛋白浓度最高的四分位数(38.93微克/毫升)的人与尿调蛋白浓度最低的四分位数的人(发病率比[IRR]，0.47；95%CI，0.29-0.79)相比，出现综合结果的风险显著较低(
Background: Laboratory studies suggest that urinary uromodulin, the most common protein in the urine of healthy adults, may protect against urinary tract infection (UTI). Epidemiologic studies evaluating this relationship in humans are lacking.Study Design: Prospective longitudinal cohort study.Setting & Participants: 953 participants enrolled in the Cardiovascular Health Study.Predictor: Uromodulin assayed using enzyme-linked immunosorbent assay in spot urine samples.Outcomes: Composite of outpatient UTI events or UTI-related hospitalizations and each of them individually identified using International Classification of Diseases, Ninth Revision (ICD-9) codes using negative binomial regression with robust standard errors adjusted for age, race, sex, body mass index, diabetes, estimated glomerular filtration rate, and urinary albumin and urinary creatinine excretion.Results: Median uromodulin level was 25.9 (IQR, 17.3-38.9) mu g/mL, mean age of participants was 78 years, 61% were women, and 15% were black. There were 331 outpatient UTI events and 87 UTI-related hospitalizations among 186 participants during a median 9.9 years of follow-up. Persons in the highest quartile (>38.93 mu g/mL) of uromodulin concentration had a significantly lower risk for the composite outcome (incidence rate ratio [IRR], 0.47; 95% CI, 0.29-0.79) compared with those in the lowest quartile (