Gender- and race-specific determination of albumin excretion rate using albumin-to-creatinine ratio in single, untimed urine specimens - The Coronary Artery Risk Development in Young Adults Study
Gender- and race-specific determination of albumin excretion rate using albumin-to-creatinine ratio in single, untimed urine specimens - The Coronary Artery Risk Development in Young Adults Study
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DOI：
10.1093/aje/155.12.1114
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发表时间：
2002-06-15
影响因子：
5
通讯作者：
Goetz, FC
中科院分区：
文献类型：
--
作者：
Jacobs, DR;Murtaugh, MA;Goetz, FC
虽然白蛋白排泄率通常使用白蛋白/肌酐比值 (A/C) 来估计，但肌酐排泄的性别和种族差异可能会导致该估计值出现偏差。作者在 1995-1996 年年轻人冠状动脉风险发展研究中优化了对 3,371 名 28-40 岁黑人和白人不定时（现货）尿液样本的使用。在第 5 年检查期间，他们使用三个 24 小时收集数据，确定黑人男性 k = 0.68 x 0.88、黑人女性 0.88、白人男性 0.68 和白人女性 1.0，以反映肌酐排泄的性别和种族差异。然后，作者通过使用 10 年检查中的不定时尿液样本，计算了肌酐排泄 (A/kC) 的种族和性别差异调整后的 A/C。 A/kC 大于或等于 25 mg/g（194 例微量白蛋白尿和 26 例临床级白蛋白尿）在黑人 (9.1%) 中比在白人 (4.2%) 中更常见，在男性 (8.2%) 中比在女性 (5.0%) 中更常见。使用未经调整的空调将男性中微量白蛋白尿的患病率低估了 52%，将黑人中的微量白蛋白尿患病率低估了 26%。调节 A/C 可以更准确地估计白蛋白排泄率。男性和黑人的白蛋白排泄率高于女性和白人，因此患微血管和大血管疾病的风险可能增加。
Although albumin excretion rate is commonly estimated by using albumin/creatinine ratio (A/C), gender and race differences in creatinine excretion may bias this estimate. The authors optimize the use of an untimed (spot) urine specimen among 3,371 Blacks and Whites aged 28-40 years in the Coronary Artery Risk Development in Young Adults Study in 1995-1996. Using three 24-hour collections during the year 5 examination, they determined k = 0.68 x 0.88 in Black men, 0.88 in Black women, 0.68 in White men, and 1.0 in White women to reflect gender and race differences in creatinine excretion. The authors then computed A/C adjusted for race and sex differences in creatinine excretion (A/kC) by using an untimed urine sample in the year 10 examination. A/kC greater than or equal to 25 mg/g (194 cases of microalbuminuria and 26 cases of clinical grade albuminuria) was more common among Blacks (9.1%) than among Whites (4.2%) and among men (8.2%) than among women (5.0%). Use of the unadjusted A/C underestimated the prevalence of microalbuminuria among men by 52% and among Blacks by 26%. Adjustment of A/C permitted more accurate estimation of albumin excretion rate. Men and Blacks have a higher albumin excretion rate than do women and Whites and may thereby have an increased risk of microvascular and macrovascular disease.