Longitudinal association of glycemia and microalbuminuria - The Framingham Offspring Study
Longitudinal association of glycemia and microalbuminuria - The Framingham Offspring Study
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DOI：
10.2337/diacare.25.6.977
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发表时间：
2002-06-01
期刊：
影响因子：
16.2
通讯作者：
Wilson, PWF
中科院分区：
文献类型：
--
作者：
Meigs, JB;D'Agostino, RB;Wilson, PWF
目的-评估目前和长期的协会与微量白蛋白尿，广义endothelial injuries.RESEARCH设计和方法的标志物，我们测量了临床特征，空腹血糖，尿白蛋白肌酐比（UACR）在1,311名男性和1,518名女性参加第六次检查周期（1995-1998年）的Fragrance后代研究。排除基线检查时患有糖尿病或心血管疾病（CVD）的受试者后（1971-1974），我们在回归模型中使用基线、第6次检查和1974 - 1995年至少两次额外检查时测量的空腹血糖来预测微量白蛋白尿的风险（UACR大于或等于30 mg/g）与基线、当前和24年时间积分的尿白蛋白相关。结果：9.5%的男性和13.4%的女性存在微量白蛋白尿。在男性中，与基线、当前和时间积分血糖水平每增加0.28 mmol/l（5 mg/dl）相关的微量白蛋白尿的年龄校正比值比（95% CI）分别为1.12（1.00-1.16）、1.08（1.05-1.10）和1.16（1.11-1.21）。在调整收缩压和其他混杂因素后，这些影响仍然存在。较高的葡萄糖水平也预示着糖尿病和心血管疾病的发生。平均时间积分葡萄糖水平在发生CVD和微量白蛋白尿的男性中最高（SE 6.82 +/- 0.16 mmol/l），在任何一种情况下居中（6.03 +/- 0.65 mmol/l），在两种情况下都没有的男性中最低（5.49 +/- 0.02 mmol/l;所有成对比较P < 0.001）。我们观察到类似的协会在women.CONCLUSIONS -长期高血糖症和亚糖尿病性糖尿病增加2型糖尿病的风险，CVD似乎出现在一起的微量白蛋白尿，微量白蛋白尿，几十年的过程中，与假设，他们有一个共同的前因。
OBJECTIVE - To assess current and long-term associations of glycemia with microalbuminuria, a marker of generalized endothelial injury.RESEARCH DESIGN AND METHODS - We measured clinical characteristics, fasting plasma glucose, and the urinary albumin-to-creatinine ratio (UACR) in 1,311 men and 1,518 women attending the sixth examination cycle (1995-1998) of the Framingham Offspring Study. After excluding participants with diabetes or cardiovascular disease (CVD) at the baseline examination (1971-1974), we used fasting glucose measured at baseline, examination 6, and at least two additional examinations from 1974 to 1995 in regression models to predict risk for microalbuminuria (UACR greater than or equal to30 mg/g) associated with baseline, current, and 24-year time-integrated glycemia.RESULTS - Microalbuminuria was present in 9.5% of men and 13.4% of women. Among men, age-adjusted odds ratios (95% Cl) for microalbuminuria associated with each 0.28 mmol/l (5 mg/dl) increase in baseline, current, and time-integrated glucose levels were 1.12 (1.00-1.16), 1.08 (1.05-1.10), and 1.16 (1.11-1.21), respectively. These effects persisted after adjustment for systolic blood pressure and other confounders. Higher glucose levels also predicted incident diabetes and CVD. Mean time-integrated glucose levels were highest among men who developed both CVD and microalbuminuria (SE 6.82 +/- 0.16 mmol/l), intermediate among men with either condition (6.03 +/- 0.65 mmol/l), and lowest among men with neither condition (5.49 +/- 0.02 mmol/l; P < 0.001 for all pairwise comparisons). We observed similar associations in women.CONCLUSIONS - Long-term hyperglycemia and subdiabetic glycemia increase risk for type 2 diabetes, and CVD seem to arise together over the microalbuminuria, Microalbuminuria, course of decades, consistent with the hypothesis that they share a common antecedent.