Low income and albuminuria among REGARDS (Reasons for Geographic and Racial Differences in Stroke) study participants.

Low income and albuminuria among REGARDS (Reasons for Geographic and Racial Differences in Stroke) study participants.
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DOI:
10.1053/j.ajkd.2012.05.010
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发表时间:
2012-11
期刊:
American journal of kidney diseases : the official journal of the National Kidney Foundation
影响因子:
--
通讯作者:
Powe NR
Powe NR
中科院分区:
其他
文献类型:
--
作者:
Crews DC;McClellan WM;Shoham DA;Gao L;Warnock DG;Judd S;Muntner P;Miller ER;Powe NR

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蛋白尿是进展性慢性肾脏病(CKD)的一个重要危险因素,在黑人成年人中比在白人成年人中更为普遍。我们试图确定低收入与蛋白尿之间的关联,以及这种关联在黑人和白人之间是否存在差异。 横断面研究。 在基于人群的“地理和种族差异对卒中影响的原因”(REGARDS)研究中,9144名45岁及以上的美国黑人成年人和13684名45岁及以上的美国白人成年人。 自我报告的家庭年收入类别(≥75000美元、35000 - 74999美元、20000 - 34999美元和<20000美元);黑人和白人种族。 蛋白尿定义为尿白蛋白 - 肌酐比值(ACR)高(30 - 300 mg/g)或极高(>300 mg/g)。多项逻辑回归用于检验收入类别与蛋白尿(正常、高或极高ACR)之间按种族分层的关联。 总体而言,几何均数ACR为10.2 mg/g,黑人(11.8 mg/g)高于白人(9.3 mg/g),p<0.001。在未调整的分析中,低收入与白人和黑人中较高的蛋白尿患病率均相关。在对人口统计学特征、生活方式因素、合并疾病和估算的肾小球滤过率进行调整后,与白人相比,黑人中较低收入水平与高ACR之间的关联有更强的趋势[对于收入水平为35000 - 74999美元、20000 - 34999美元和<20000美元,比值比分别为1.38(95%置信区间,1.07 - 1.77)、1.36(95%置信区间,1.05 - 1.75)和1.58(95%置信区间,1.21 - 2.05);参考组为收入≥75000美元的人群],而白人的比值比分别为0.95(95%置信区间,0.81 - 1.12)、0.95(95%置信区间,0.79 - 1.14)和1.26(95%置信区间,1.02 - 1.55);种族和收入之间的交互作用P值为0.08。对于极高ACR以及患有糖尿病或高血压的参与者亚组,结果相似。 横断面设计;并非所有REGARDS参与者都提供了他们的年收入。 低收入与黑人蛋白尿的关联可能比与白人的更强,并且可能是蛋白尿种族差异的一个决定因素。
Albuminuria is an important risk factor for progressive CKD and is more prevalent among black than among white adults. We sought to determine the association between low income and albuminuria, and if this association differs for blacks and whites. Cross-sectional study. 9,144 black and 13,684 white U.S. adults aged 45 years and older in the population-based REasons for Geographic and Racial Differences in Stroke (REGARDS) study. Self-reported annual household income category (≥$75,000, 35,000 – $74,999, $20,000 – $34,999, and <$20,000); black and white race. Albuminuria defined as high (30 to 300 mg/g) or very high (>300 mg/g) urinary albumin-creatinine ratio (ACR). Multinomial logistic regression used to examine the race-stratified association between categories of income and albuminuria (normal, high, or very high ACR). Overall, geometric mean ACR was 10.2 mg/g, and was higher for blacks (11.8 mg/g) than for whites (9.3 mg/g), p <0.001. Lower income was associated with a higher prevalence of albuminuria for both whites and blacks in unadjusted analyses. After adjustment for demographics, lifestyle factors, comorbid illnesses and estimated glomerular filtration rate, there was a trend towards a stronger association between lower income levels and high ACR among blacks [ORs of 1.38 (95% CI, 1.07 – 1.77), 1.36 (95% CI, 1.05 – 1.75), and 1.58 (95% CI, 1.21–2.05), for income levels of $35,000 – $74,999, $20,000 – $34,999, and <$20,000, respectively; reference group is those with income ≥$75,000] compared to whites [ORs of 0.95 (95% CI, 0.81 – 1.12), 0.95 (95% CI, 0.79 – 1.14), and 1.26 (95% CI, 1.02 – 1.55), respectively]; P interaction 0.08 between race and income. Results were similar for very high ACR, and subgroups of participants with diabetes or hypertension. Cross-sectional design; not all REGARDS participants provided their annual income. Lower income may be more strongly associated with albuminuria among blacks than among whites, and may be a determinant of racial disparities in albuminuria.
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