Relationship of serum bilirubin concentrations to kidney function and albuminuria in the United States adult population. Findings from the National Health and Nutrition Examination Survey 2001-2006
Relationship of serum bilirubin concentrations to kidney function and albuminuria in the United States adult population. Findings from the National Health and Nutrition Examination Survey 2001-2006
复制标题
DOI：
10.1515/cclm.2009.244
复制
发表时间：
2009-09-01
影响因子：
6.8
通讯作者：
Chonchol, Michel
中科院分区：
文献类型：
--
作者：
Targher, Giovanni;Bosworth, Cortney;Chonchol, Michel
背景资料：在美国普通人群中，血清胆红素浓度与肾功能和蛋白尿之间的关系尚未建立。我们对2001-2006年国家健康与营养调查（NHANES）的数据进行了横断面分析，并检查了血清总胆红素浓度与估计肾小球滤过率（eGFR）的相关性。和白蛋白尿的全国代表性样本的13,184名成人年龄在20岁或以上。使用简化的肾脏疾病饮食改良公式估计eGFR。结果：eGFR < 60 mL/min/1.73 m2和尿白蛋白/肌酐比值>= 30 mg/g的受试者分别占8.1%（n=1072）和10.6%（n=1402）。血清总胆红素浓度> 22.23 μ mol/L者共427例（3.2%）。在调整人口统计学、合并症、饮酒、病毒性肝炎状态和其他实验室指标后，在整个队列和非糖尿病个体亚组中，血清胆红素与eGFR呈负相关，与白蛋白尿呈正相关。相反，血清胆红素与糖尿病患者（n=1253）的eGFR或白蛋白尿无显著相关性（n=1253）。结论：在美国成人人群中，血清总胆红素浓度升高与eGFR降低和白蛋白尿增加独立相关。临床化学实验室医学2009;47：1055-62。
Background: The association of serum bilirubin concentrations with kidney function and albuminuria has not been established in the US general population.Methods: We performed a cross-sectional analysis of data from the National Health and Nutrition Examination Survey (NHANES) 2001-2006 and examined the associations of serum total bilirubin concentrations with estimated glomerular filtration rate (eGFR) and albuminuria in a nationally representative sample of 13,184 adults aged 20 years or older. eGFR was estimated using the abbreviated Modification of Diet in Renal Disease equation. Urinary albumin excretion was measured using the albumin/creatinine ratio.Results: An eGFR < 60 mL/min/1.73 m(2) and urinary albumin/creatinine ratio >= 30 mg/g were present in 8.1% (n=1072) and 10.6% (n=1402) of participants, respectively. A total of 427 (3.2%) individuals had a serum total bilirubin concentration > 22.23 mu mol/L. After adjustment for demographics, comorbidities, alcohol consumption, viral hepatitis status and other laboratory measures, serum bilirubin was negatively associated with eGFR, and positively with albuminuria both in the whole cohort and in the subgroup of non-diabetic individuals. In contrast, serum bilirubin was not significantly associated with eGFR or albuminuria in persons with diabetes (n=1253).Conclusions: Increasing serum concentrations of total bilirubin are independently associated with decreasing eGFR and increasing albuminuria in the US adult population. Clin Chem Lab Med 2009;47:1055-62.