Albuminuria, cognitive functioning, and white matter hyperintensities in homebound elders.
Albuminuria, cognitive functioning, and white matter hyperintensities in homebound elders.
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DOI：
10.1053/j.ajkd.2008.08.022
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发表时间：
2009-03
期刊：
影响因子：
--
通讯作者：
Sarnak MJ
中科院分区：
文献类型：
--
作者：
Weiner DE;Bartolomei K;Scott T;Price LL;Griffith JL;Rosenberg I;Levey AS;Folstein MF;Sarnak MJ
蛋白尿是微血管疾病的肾脏标志物，可能预示着其他地方的微血管疾病，包括大脑。横截面。马萨诸塞州波士顿（美国）接受家庭健康服务以维持独立生活并同意脑磁共振成像的老年人。尿白蛋白与肌酐比值（ACR）。使用主成分分析和脑成像白质高强度体积评估执行功能和记忆的认知电池性能，在逻辑和线性回归模型中进行评估。335名参与者的平均年龄为73.4±8.1岁；123名参与者有微量白蛋白尿或大量白蛋白尿。ACR每增加一倍与执行功能恶化相关[单变量分析β=-0.05 (p=0.005)，多变量分析β=-0.07 (p=0.004)，控制了年龄、性别、种族、教育程度、糖尿病、心血管疾病、高血压、药物和肾小球滤过率]，但与记忆或工作记忆恶化无关。微量白蛋白尿或大量白蛋白尿的个体更有可能处于执行功能较低的胎位数，而不是最高的胎位数[单变量和多变量分析中，ACR每加倍的优势比分别为1.18（1.06至1.32）和1.19(1.05至1.35)]。在单变量和多变量分析中，蛋白尿与定性白质高强度分级相关[比值比分别为1.13（1.02 - 1.25）和1.15 (1.02 - 1.29)/ ACR加倍]，在对数转换数据的单变量和多变量分析中，蛋白尿与定量白质高强度体积相关[β=0.11 （p=0.007）和β=0.10 (p=0.01)]。当排除大量蛋白尿患者时，结果相似。单次测量ACR、间接肌酐校准和依赖参与者回忆病史的因素，蛋白尿与认知能力下降有关，特别是在执行功能方面，以及白质高强度体积增加。蛋白尿可能表明更大的脑微血管疾病负担。
Albuminuria, a kidney marker of microvascular disease, may herald microvascular disease elsewhere, including in the brain. Cross sectional. Boston, MA (USA) elders receiving home health services to maintain independent living who consented to brain magnetic resonance imaging. Urine albumin to creatinine ratio (ACR). Performance on a cognitive battery assessing executive function and memory using principal components analysis and white matter hyperintensity volume on brain imaging, evaluated in logistic and linear regression models. Of 335 participants, mean age was 73.4 ± 8.1 years; 123 participants had microalbuminuria or macroalbuminuria. Each doubling of ACR was associated with worse executive function [β=-0.05 (p=0.005) in univariate and β=-0.07 (p=0.004) in multivariable analyses controlling for age, sex, race, education, diabetes, cardiovascular disease, hypertension, medications, and estimated glomerular filtration rate] but not with worse memory or working memory. Individuals with microalbuminuria or macroalbuminuria were more likely to be in the lower versus the highest tertile of executive functioning [Odds ratio =1.18 (1.06 to 1.32) and 1.19 (1.05 to 1.35) per doubling of ACR in univariate and multivariable analyses, respectively]. Albuminuria was associated with qualitative white matter hyperintensity grade [Odds ratio =1.13 (1.02 to 1.25) and 1.15 (1.02 to 1.29) per doubling of ACR] in univariate and multivariable analyses, and with quantitative white matter hyperintensity volume [β=0.11 (p=0.007) and β=0.10 (p=0.01)] in univariate and multivariable analyses of log-transformed data, respectively. Results were similar when excluding individuals with macroalbuminuria. Single measurement of ACR, indirect creatinine calibration and reliance on participant recall for elements of medical history Albuminuria is associated with worse cognitive performance, particularly in executive functioning, as well as increased white matter hyperintensity volume. Albuminuria likely identifies greater brain microvascular disease burden.
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影响因子：
--
作者：
Seshadri S;DeStefano AL;Au R;Massaro JM;Beiser AS;Kelly-Hayes M;Kase CS;D'Agostino RB Sr;Decarli C;Atwood LD;Wolf PA
通讯作者：
Wolf PA
DOI：
10.1097/01.asn.0000131529.60019.fa
发表时间：
2004-07-01
影响因子：
13.6
作者：
Seliger, SL;Siscovick, DS;Kuller, LH
通讯作者：
Kuller, LH
影响因子：
11.1
作者：
Kuo, H.-K.;Lin, L.-Y.;Yu, Y.-H.
通讯作者：
Yu, Y.-H.
影响因子：
--
作者：
Lopez, OL;Jagust, WJ;Kuller, LH
通讯作者：
Kuller, LH
影响因子：
13.6
作者：
Seliger, SL;Longstreth, WT;Siscovick, DS
通讯作者：
Siscovick, DS