Elevated High Sensitivity C-Reactive Protein Increases the Risk of Microalbuminuria in Subjects With Cardiovascular Disease Risk Factors
Elevated High Sensitivity C-Reactive Protein Increases the Risk of Microalbuminuria in Subjects With Cardiovascular Disease Risk Factors
复制标题
高敏 C 反应蛋白升高会增加患有心血管疾病危险因素的受试者出现微量白蛋白尿的风险
DOI：
10.1111/1744-9987.12530
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发表时间：
2017
影响因子：
1.9
通讯作者：
Zhang Hao
中科院分区：
文献类型：
--
作者：
Yang Shi-kun;Liu Jun;Yi Bin;Mao Juan;Zhang Xian-ming;Liu Yan;Lei Dan-dan;Gui Ming;Zhang Hao
微量白蛋白尿是肾脏损伤的早期生物标志物，本研究旨在探讨高敏C反应蛋白(hs-CRP)对具有心血管疾病(CVD)危险因素的成人微量白蛋白尿的影响。在中南大学湘雅第三医院自愿参加年度健康筛查的5667名受试者被纳入研究。用Logistic回归分析hs-CRP预测微量白蛋白尿的有效性。在非校正回归分析中，男性(OR 2.23)、年龄(OR 1.71)、吸烟(OR 1.48)、肥胖(OR 2.41)、高血压(OR 4.03)、糖尿病(OR 4.61)、高尿酸血症(OR 1.83)和高hs-CRP(OR 1.61)与微量白蛋白尿有关。多因素Logistic回归分析显示，糖尿病、高血压、男性、腹型肥胖和高hs-CRP对微量白蛋白尿的调整优势比(OR)分别为2.71、2.57、1.51、1.28和1.41(P<0.01)。ROC分析表明，hs-C反应蛋白筛查微量白蛋白尿的临界值为≥0.85 mg/L，男性、腹型肥胖、糖尿病和高血压患者发生微量白蛋白尿的OR值分别为男性、腹型肥胖、糖尿病和高血压患者的1.97倍、1.49倍、1.32倍和1.71倍(P<；0.01)。超敏C反应蛋白水平升高与微量白蛋白尿相关，与心血管危险因素无关。此外，在具有CVD危险因素的人群中，hs-CRP升高增加了发生微量白蛋白尿的风险，表明慢性炎症可通过CVD危险因素的影响放大肾脏的恶化。
Microalbuminuria is an early biomarker of kidney injury, the aim of this study was to investigate the impact of high sensitivity C‐reactive protein (hs‐CRP) on microalbuminuria in adults with cardiovascular disease (CVD) risk factors. A total of 5667 subjects who voluntarily attended annual health screenings in the Third Xiangya Hospital of Central South University were included in the study. Logistic regression was used to determine the validity of hs‐CRP to predict the presence of microalbuminuria. In the unadjusted regression analysis, male gender (OR 2.23), age (OR 1.71), smoking status (OR 1.48), obesity (OR 2.41), hypertension(OR 4.03), diabetes (OR 4.61), hyperuricemia (OR 1.83), and high hs‐CRP(OR 1.61) were associated with microalbuminuria. Multivariate logistic regression analysis showed that the adjusted odds ratios (OR) of diabetes, hypertension, male, abdominal obesity, and high hs‐CRP for microalbuminuria were 2.71, 2.57, 1.51, 1.28 and 1.41 in all subjects, respectively (P< 0.01). ROC analysis indicated that the cut‐off for hs‐CRP with better properties for screening of microalbuminuria was identified as ≥0.85 mg/L. The ORs of microalbuminuria were 1.97, 1.49, 1.32 and 1.71 times in male, abdominal obesity, diabetes and hypertension subjects with hs‐CRP ≥ 0.85 mg/L, respectively, compared with those without elevated hs‐CRP (P< 0.01). Elevated hs‐CRP level was associated with microalbuminuria independent of cardiovascular risk factors. In addition, elevated hs‐CRP increased the risk of developing microalbuminuria in subjects with CVD risk factors, indicating that chronic inflammation could amplify the deterioration of kidney by effect of CVD risk factors.