High variability of albuminuria in nondiabetic population: the Takahata Study
High variability of albuminuria in nondiabetic population: the Takahata Study
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DOI：
10.1007/s10157-009-0177-3
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发表时间：
2009-10-01
影响因子：
2.3
通讯作者：
Kubota, Isao
中科院分区：
文献类型：
--
作者：
Suzuki, Kazuko;Konta, Tsuneo;Kubota, Isao
白蛋白尿是肾脏和心血管事件的危险因素，并显示出反映血管状态的快速变化。本研究以2004年和2005年在日本高幡町参加社区健康检查的1,378名（平均年龄63.9岁）非糖尿病人群为研究对象，探讨蛋白尿短期变化的频率和相关因素。通过晨尿中白蛋白/肌酐比值评估白蛋白尿，并将其分为4个阶段（正常低值、正常高值、微量和大量白蛋白尿）。基线时，正常低值、正常高值、微量和大量白蛋白尿的患病率分别为62.3%、17.3%、18.7%和1.7%。在1年期间，分别在23.1%和14.5%的受试者中观察到白蛋白尿阶段的进展和缓解。进展和缓解的白蛋白尿，经常检测到在每个阶段，特别是在高正常白蛋白尿（29%的进展和39%的缓解，分别）。多因素分析显示，白蛋白尿的变化与年龄、血压、总蛋白、肾小球滤过率（GFR）、基线尿钠排泄、开始使用抗糖尿病药物、体重变化相关（+/- 1 kg），血红蛋白（+/- 1 g/dl），和尿钠排泄该研究揭示，在1年期间，白蛋白尿显示出与年龄相关的高变异性和可改变的风险因素的小变化。在蛋白尿受试者的治疗和风险分析中，应考虑这些因素的影响。
Albuminuria is a risk factor for renal and cardiovascular events and shows a quick change reflecting vascular status. The aim of this study is to examine the frequency and related factors of the short-term change of albuminuria in nondiabetic Japanese population.The study subjects were 1,378 individuals (mean age 63.9 years) who attended community-based health checkup in 2004 and 2005 in Takahata town. Albuminuria was evaluated by urine albumin creatinine ratio in morning urine and was categorized into four stages (low normal, high normal, and micro- and macroalbuminuria).At baseline, the prevalence of subjects with low normal, high normal, and micro- and macroalbuminuria was 62.3, 17.3, 18.7, and 1.7%, respectively. During 1 year, progression and remission of albuminuria stages were observed in 23.1 and 14.5% of total subjects, respectively. Both progression and remission of albuminuria were frequently detected at every stage, especially in high normal albuminuria (29% in progression and 39% in remission, respectively). On multivariate analysis, the changes of albuminuria were associated with older age, blood pressures, total protein, estimated glomerular filtration rate (GFR), and urine sodium excretion at baseline, start of antidiabetic drugs, changes in body weight (+/- 1 kg), hemoglobin (+/- 1 g/dl), and urine sodium excretion (+/- 50 mEq/day).This study revealed that albuminuria showed high variability associated with age and small changes in modifiable risk factors during 1 year. In the treatment and risk analysis of subjects with albuminuria, the effect of these factors should be considered.