Microalbuminuria is strongly associated with NIDDM and hypertension, but not with the insulin resistance syndrome: the Hoorn study
Microalbuminuria is strongly associated with NIDDM and hypertension, but not with the insulin resistance syndrome: the Hoorn study
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DOI：
10.1007/s001250050970
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发表时间：
1998-06-01
期刊：
影响因子：
8.2
通讯作者：
Stehouwer, CDA
中科院分区：
文献类型：
--
作者：
Jager, A;Kostense, PJ;Stehouwer, CDA
微量白蛋白尿是心血管疾病的有力预测因子。本研究的目的是调查微量白蛋白尿是否是胰岛素抵抗综合征 (IRS) 等一系列危险因素的一部分，或者它是否仅与高血压和非胰岛素依赖型糖尿病 (NIDDM) 有关，并且可能是高血压和非胰岛素依赖型糖尿病 (NIDDM) 的并发症。对来自 50-75 岁一般人群 (n = 622) 的年龄、性别和葡萄糖耐量分层随机样本进行了调查。在清晨点尿样本中测量尿白蛋白与肌酐的比率。微量白蛋白尿定义为白蛋白与肌酐的比率大于 2.0 mg/mmol。作为 IRS 相关变量，我们考虑了空腹高胰岛素血症、胰岛素抵抗（IR；根据稳态模型评估公式计算）、血脂异常、葡萄糖耐受不良、高血压和腰臀比 (WHR)。血脂异常定义为最低三分位数中的高密度脂蛋白胆固醇水平和/或最高三分位中的甘油三酯水平。空腹胰岛素水平、IR 和 WHR 分为三分位数；将最高三分位数与最低三分位数进行比较。年龄、性别和糖耐量调整分析显示微量白蛋白尿与高血压、NIDDM 和 WHR 显着相关。在多重 Logistic 回归分析中，微量白蛋白尿显示出与高血压、NIDDM 和 WHR 独立相关，比值比 (ORs [95% 置信区间]) 分别为 3.33 (1.86-5.96)、2.26 (1.14-4.48) 和 2.49 (1.09-5.70)。未发现与糖耐量受损、高胰岛素血症、IR 或血脂异常相关。糖尿病和非糖尿病受试者的多元逻辑回归分析分别显示微量白蛋白尿仅与高血压独立相关（OR 4.31 和 2.69）。在这个白人群体中，微量白蛋白尿与高血压、NIDDM 和 WHR 相关，但与 IRS 的其他变量无关。因此，微量白蛋白尿很可能是高血压和 NIDDM 的并发症，而不是 IRS 的组成部分。
Microalbuminuria is a strong predictor of cardiovascular disease. The aim of this study was to investigate whether microalbuminuria is part of a cluster of risk factors, the insulin resistance syndrome (IRS), or whether it is only associated with, and presumably a complication of, hypertension and non-insulin-dependent diabetes mellitus (NIDDM). An age-, sex-and glucose tolerance-stratified random sample from a 50-75 year old general population (n = 622) was investigated. The urinary albumin-to-creatinine ratio was measured in an early morning spot urine sample. Microalbuminuria was defined as an albumin-to-creatinine ratio greater than 2.0 mg/mmol. We considered, as IRS-related variables, fasting hyperinsulinaemia, insulin resistance (IR; calculated from the formula of the homeostasis model assessment), dyslipidaemia, glucose intolerance, hyper tension and waist-to-hip ratio (WHR). Dyslipidaemia was defined as levels of HDL-cholesterol In the lowest and/or levels of triglyceride in the highest tertile. Fasting insulin levels, IR and WHR were divided into tertiles; the highest tertiles were compared to the lowest tertiles. Age-, sex-and glucose tolerance-adjusted analyses showed microalbuminuria to be significantly associated with hypertension, NIDDM and WHR. In multiple logistic regression analyses, microalbuminuria showed independent associations with hypertension, NIDDM and WHR, with odds ratios (ORs [95% confidence interval]) of 3.33 (1.86-5.96), 2.26 (1.14-4.48) and 2.49 (1.09-5.70), re respectively. No associations were found with impaired glucose tolerance, hyperinsulinaemia, IR or dyslipidaemia. Multiple logistic regression analyses in diabetic and non-diabetic subjects separately showed that microalbuminuria was independently associated only with hypertension (ORs 4.31 and 2.69). In this Caucasian population, microalbuminuria was associated with hypertension, NIDDM and WHR and not with other variables of the IRS. It is therefore likely that microalbuminuria is a complication of hypertension and NIDDM, and not an integral part of the IRS.