Albuminuria as a Risk Factor for Peripheral Arterial Disease in a General Population-The Hisayama Study
Albuminuria as a Risk Factor for Peripheral Arterial Disease in a General Population-The Hisayama Study
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DOI：
10.5551/jat.7682
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发表时间：
2011-01-01
影响因子：
4.4
通讯作者：
Kiyohara, Yutaka
中科院分区：
文献类型：
--
作者：
Usui, Tomoko;Ninomiya, Toshiharu;Kiyohara, Yutaka
目的：阐明蛋白尿与外周动脉疾病（PAD）患病率之间的关系，并在日本普通人群中检测蛋白尿对评估PAD可能性的影响。方法：在3,061名年龄≥ 40岁的社区居民中，我们调查了尿白蛋白-肌酐比值（UACR）水平与PAD患病率的关系，定义为踝臂指数< 0.9。使用逻辑回归模型估计PAD存在的比值比。为了比较评估的准确性之间的可能性普遍PAD调整的潜在危险因素与UACR水平，受试者工作特征（ROC）curves were plotted.Results：总体而言，1.47%的研究参与者有PAD。当UACR水平为< 5.6、5.6-10.8、10.9-29.9、30.0-300.0和> 300.0 mg/g时，年龄和性别校正的PAD患病率线性增加，分别为0.34、0.80、2.02、2.50和2.53%（趋势p < 0.001）。对于UACR每增加10倍，PAD存在的多变量校正比值比为1.85（95%置信区间1.12-3.06）。当UACR水平被纳入PAD潜在危险因素模型时，ROC曲线下面积显著增加（0.80 vs. 0.77，p = 0.02）。在日本普通人群中，较高的UACR水平与较高的PAD患病率呈线性相关，即使在正常白蛋白尿范围内，并且将UACR水平与潜在的危险因素相结合显著提高了评估PAD可能性的性能。
Aims: To elucidate the relationship between albuminuria and the prevalence of peripheral arterial disease (PAD), and to examine the effect of albuminuria on the ability to assess the likelihood of PAD in a general Japanese population.Methods: In 3,061 community-dwelling subjects aged >= 40 years, we investigated the association of urinary albumin-creatinine ratio (UACR) levels with the prevalence of PAD, defined as an ankle-brachial index < 0.9. The odds ratio for the presence of PAD was estimated using the logistic regression model. To compare the accuracy of the assessment for the likelihood of prevalent PAD between models adjusted for potential risk factors with and without UACR levels, the receiver operating characteristic (ROC) curves were plotted.Results: Overall, 1.47% of the study participants had PAD. The age-and sex-adjusted prevalence of PAD increased linearly for UACR levels of < 5.6, 5.6-10.8, 10.9-29.9, 30.0-300.0, and > 300.0 mg/g, being 0.34, 0.80, 2.02, 2.50, and 2.53%, respectively (p for trend < 0.001). The multivariate-adjusted odds ratio for the presence of PAD was 1.85 (95% confidence interval 1.12-3.06) for every 10-fold increment in UACR. The area under the ROC curve significantly increased when UACR levels were incorporated into a model with potential risk factors for PAD (0.80 vs. 0.77, p = 0.02).Conclusion: Greater UACR levels are associated linearly with a higher prevalence of PAD, even within the normoalbuminuric range, in the general Japanese population, and combining UACR levels with potential risk factors substantially improves the performance to assess the likelihood of PAD.