Halimi J M, Forhan A, Balkau B, Novak M, Wilpart E, Tichet J, Marre M
Centre de Recherche Clinique, Tours University and Nephrology Department, CHU Tours, France.
J Cardiovasc Risk. 2001 Jun;8(3):139-46. doi: 10.1177/174182670100800304.
Microalbuminuria is associated with some cardiovascular risk factors. However, it is presently unclear whether microalbuminuria is associated with other cardiovascular risk factors and markers of insulin resistance in both men and women.
The baseline parameters of the on-going prospective D.E.S.I.R. Study (Data from an Epidemiological Study on the Insulin Resistance syndrome) were analysed.
The subjects (n = 3878, age 30-64) had a medical and biological checkup including arterial pressure, ECG, lipids, haematocrit, leukocyte count, insulin and urinary albumin concentration.
Arterial pressure was significantly higher in microalbuminuric than in normoalbuminuric men and women. The heart rate and the prevalence of smoking were higher in microalbuminuric than in normoalbuminuric men, but not in women. Total- and LDL-cholesterol, triglycerides, apolipoprotein-B, leukocyte count, uric acid, haematocrit, haemoglobin and red cell volume were greater in microalbuminuric than in normoalbuminuric men. Total- and HDL-cholesterol were lower whereas triglycerides and uric acid were significantly greater in microalbuminuric than in normoalbuminuric women. The 9-year calculated absolute cardiovascular risk was higher in microalbuminuric than in normoalbuminuric men (4.18% vs. 2.79%, respectively, P < 0.0001) but was similar in women (0.75% vs. 0.69%, respectively, NS). Fasting blood glucose and insulin were higher in microalbuminuric than in normoalbuminuric men, but not in women. A multiple regression showed that microalbuminuria was associated with systolic arterial pressure, fasting glucose, leukocyte count and haematocrit in men, and with systolic arterial pressure and triglycerides in women.
Microalbuminuria is associated with most cardiovascular risk factors and markers of insulin resistance in men, but no consistent association is observed in women. The determinants of microalbuminuria appear different in men and women, suggesting a different pathophysiology and perhaps significance of microalbuminuria in men and women.
微量白蛋白尿与一些心血管危险因素相关。然而，目前尚不清楚微量白蛋白尿是否与男性和女性的其他心血管危险因素及胰岛素抵抗标志物相关。
对正在进行的前瞻性D.E.S.I.R.研究（胰岛素抵抗综合征流行病学研究数据）的基线参数进行分析。
受试者（n = 3878，年龄30 - 64岁）接受了包括动脉压、心电图、血脂、血细胞比容、白细胞计数、胰岛素和尿白蛋白浓度在内的医学和生物学检查。
微量白蛋白尿组男性和女性的动脉压显著高于正常白蛋白尿组。微量白蛋白尿组男性的心率和吸烟患病率高于正常白蛋白尿组男性，但女性中无此差异。微量白蛋白尿组男性的总胆固醇、低密度脂蛋白胆固醇、甘油三酯、载脂蛋白B、白细胞计数、尿酸、血细胞比容、血红蛋白和红细胞体积均高于正常白蛋白尿组男性。微量白蛋白尿组女性的总胆固醇和高密度脂蛋白胆固醇较低，而甘油三酯和尿酸显著高于正常白蛋白尿组女性。微量白蛋白尿组男性9年计算出的绝对心血管风险高于正常白蛋白尿组男性（分别为4.18%对2.79%，P < 0.0001），但女性中相似（分别为0.75%对0.69%，无显著性差异）。微量白蛋白尿组男性的空腹血糖和胰岛素高于正常白蛋白尿组男性，但女性中无此差异。多元回归显示，男性中微量白蛋白尿与收缩压、空腹血糖、白细胞计数和血细胞比容相关，女性中与收缩压和甘油三酯相关。
微量白蛋白尿与男性的大多数心血管危险因素及胰岛素抵抗标志物相关，但在女性中未观察到一致的关联。微量白蛋白尿的决定因素在男性和女性中似乎不同，提示微量白蛋白尿在男性和女性中的病理生理学及可能的意义不同。
