Lower aldosterone-renin ratio is a risk factor for total and cancer death in Japanese individuals: the Takahata study.
Lower aldosterone-renin ratio is a risk factor for total and cancer death in Japanese individuals: the Takahata study.
复制标题
较低的醛固酮-肾素比率是日本人总死亡和癌症死亡的危险因素：高畑研究。
DOI：
10.1111/cen.12615
复制
发表时间：
2015
期刊：
影响因子：
--
通讯作者：
Kato T.
中科院分区：
文献类型：
--
作者：
Daimon M;Konta T;Oizumi T;Kameda W;Susa S;Terui K;Nigawara T;Kageyama K;Ueno Y;Kubota I;Yamashita H;Kayama T;Kato T.
目的血浆中较高的醛固酮/肾素比值(ARR)是筛选原发性醛固酮增多症(PA)的可靠指标。在普通人群中，较高的ARR与死亡率之间的关系尚未得到充分的研究。我们在这里检验了较高的ARR是否是日本人口总死亡率和特定原因死亡率的风险因素。受试者和方法一项以人群为基础的纵向研究，对象为1310名日本人(年龄：63.9岁±9.8岁)，在2004至2006年间参加了Takahata研究，并进行了长达8年的跟踪调查。每年监测发病情况和死亡原因，直至2012年1月10日(中位随访：2691天)。结果在随访期内，受试者死亡。Kaplan-Meier分析显示，在ARR较低的受试者中，总风险和癌症死亡率显著增加(log-rankP<；=0.001)。调整年龄和性别的COX比例风险模型分析表明，在低(≦72)和高(72)ARR的受试者中，较低的ARR与总死亡率和癌症死亡率的增加相关(危险比和95%可信区间分别为2.56，1.44-4.56和2.78，1.16-6.65)。结论低ARR是日本人群总死亡率和癌症死亡率增加的一个重要的独立危险因素。ARR较高的受试者总体上不存在总死亡风险。这些发现增加了区分PA患者和ARR较高患者的必要性。没有PA的ARR较高的人总死亡和癌症死亡的风险可能非常低。
ObjectiveA higher plasma aldosterone–renin ratio (ARR) is an established marker for screening for primary aldosteronism (PA). The association between higher ARR and mortality in a general population has not been fully explored. We here examined whether higher ARR is a risk factor for total and cause‐specific mortality in a Japanese population.Subjects and MethodsA population‐based, longitudinal study of 1,310 Japanese individuals (age: 63·9 ± 9·8 years) enrolled in the Takahata study between 2004 and 2006 and followed for up to 8 years. The incidence and causes of death were monitored annually until 10 January 2012 (median follow‐up: 2691 days).ResultsDuring the follow‐up period, 64 subjects died. Kaplan–Meier analysis showed a significantly increased risk for total and cancer mortality in subjects with lower ARR (log‐rankP< 0·001). Cox's proportional hazard model analyses with adjustment for age and gender showed that lower ARR was associated with increased total and cancer mortality in subjects with low (≦72)vshigh (>72) ARR (hazard ratios and 95% confidential intervals: 2·56, 1·44–4·56 and 2·78, 1·16–6·65, respectively).ConclusionsLower ARR was a significant and independent risk factor for increased total and cancer mortality in this Japanese population. Subjects with higher ARR were not‐at‐risk for total death in general. These findings increase the necessity for identifying people with PA from those with higher ARR. People with higher ARR without PA may be at very low risk for total and cancer death.