Association between urinary albumin and cerebrovascular disease in healthy women

Iwate-Kenpoku队列（Iwate-KENCO）研究旨在前瞻性调查日本北部地区普通人群中风和心血管疾病的风险。作为政府规定的普通民众健康检查的一部分，进行了一项基线调查。从2002年到2004年，26,469名参与者（9,161名男性和17,308名女性）参加了该计划。在这些参与者中，25,713名参与者测量了尿白蛋白。在这项研究中，我们使用的受试者年龄在40至74岁之间，没有中风史。具有以下特征的受试者被排除在外；血尿，糖化血红蛋白bbb65 %，随机血糖>200mg/dl。因此，对6443名男性和13494名女性进行了最后的统计分析。平均随访时间为27年，共有54,019人年的观察，在此期间，男性和女性共发生183例死亡和232例中风事件。采用Cox比例风险模型，根据A点尿白蛋白与肌酐比（UACR）四分位数计算各组全因死亡和卒中发生率的年龄校正和多重校正风险比（HR）。在女性中，Q2、Q3和Q4与Q1的全因死亡的多变量校正HR （95%CI）分别为243（104,5.69）、191（80,4.56）和209（0.85,510）。女性发生脑卒中的多重校正风险比分别为0.77（0.40,1.50）、1.09（0.58,2.03）、158（0.86,2.87）。在女性中，对对数UACR进行多变量调整后的卒中HR为124（106,1.47）。这些结果表明UACR是女性中风的一个重要标志。

The Iwate-Kenpoku cohort (Iwate-KENCO) study is designed to prospectively investigate the risks of stroke and cardiovascular disease in a general population in northern area in Japan. A baseline survey was conducted as a part of a government regulated health check up for the general population. From 2002 to 2004, 26,469 participants (9,161 males and 17,308 females) took part in the program. Of these participants, 25,713 participants were measured urinary albumin. In this study, we used subject aged 40 to 74, without history of stroke. Subjects with the following characteristics were excluded; hematuria, HbA1c>6 5% and casual blood sugar>200mg/dl. The final statistical analysis was therefore performed in 6,443 males and 13,494 females. The mean follow-up period was 2 7 years, there were 54,019 person-years of observation and 183 deaths and 232 incident cases of stroke occurred during this period for men and women. Age-adjusted and multiple adjusted hazard ratios (HR) for all-cause death and incident case of stroke were calculated in each group according to A spot urine albumin to creatinine ratio (UACR) quartile by Cox proportional hazard model. In females, the multivariable-adjusted HR (95%CI)of all-cause death for Q2, Q3 and Q4 versus Q1 was 2 43 (104, 5.69), 191 (0 80, 4 56) and 2 09 (0.85, 510). The multiple adjusted HR of incident stroke in females was 0.77 (0.40, 1.50), 1.09 (0 58, 2 03), 158 (0 86, 2 87). In females, the multivariable-adjusted HR of stroke for logarithmic UACR was 124 (106, 1.47).These results suggest the UACR is an important marker for stroke in females.