American Indian heritage and risk factors for renal injury
American Indian heritage and risk factors for renal injury
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DOI：
10.1046/j.1523-1755.1998.00106.x
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发表时间：
1998-10-01
影响因子：
19.6
通讯作者：
Croft, JB
中科院分区：
文献类型：
--
作者：
Kasiske, BL;Rith-Najarian, S;Croft, JB
背景鲜为人知的是，在美国的五大湖地区的美国印第安人之间的肾脏疾病的原因和后果。我们采用单变量和多变量分析方法，对部落间心脏项目的三个部落社区的1368名参与者进行了白蛋白/肌酐比值的临床相关性研究。与1086名无蛋白尿的受试者相比，240名微量白蛋白尿（30 - 299 mg/g）和42名大量白蛋白尿（>300 mg/g）的受试者更可能报告心肌梗死病史（分别为6.4%，16.0%和23.8%，P < 0.001）。同样，与无蛋白尿的患者相比，有微量白蛋白尿和大量白蛋白尿的患者更可能报告卒中史（分别为2.3%、8.4%和26.2%，P < 0.001）。多元线性回归模型显示，与白蛋白排泄相关的独立因素（P < 0.05）包括：空腹血糖、糖尿病治疗、高血压治疗、收缩压升高、舒张压降低、心电图异常、卒中史、美国印第安血统程度和家庭收入较低。尿白蛋白排泄与五大湖地区美洲印第安人心血管疾病结局和危险因素相关遗传和社会经济地位似乎在这一人群中肾损伤的发病机制中起作用。
Background. Little is known about the causes and consequences of renal disease among American Indians in the Great Lakes region of the United States.Methods. We examined clinical correlates of albumin/creatinine ratios among 1368 participants in the three tribal communities of the Inter-Tribal Heart Project using univariate and multivariate analysis.Results. Compared to 1086 participants without albuminuria, the 240 with microalbuminuria (30 to 299 mg/g) and the 42- with macroalbuminuria (>300 mg/g) were more likely to report a history of a myocardial infarction (6.4%, 16.0%, and 23.8%, respectively, P < 0.001). Similarly, compared to patients without albuminuria, those with microalbuminuria and macroalbuminuria were more likely to report a history of stroke (2.3%, 8.4% and 26.2%, respectively, P < 0.001). In a multiple linear regression model, independent correlates of albumin excretion (P < 0.05) included: fasting blood sugar, treated diabetes, treated hypertension, higher systolic blood pressure, lower diastolic blood pressure, abnormal electrocardiogram, a history of stroke, the degree of American Indian heritage, and lower household income.Conclusions. Urinary albumin excretion is associated with cardiovascular disease outcomes and risk factors among American Indians of the Great Lakes region. Both heredity and socioeconomic status appear to play a role in the pathogenesis of renal injury in this population.