Hoq Sheikh, Chen Wei, Srinivasan Sathanur R, Berenson Gerald S
Tulane Center for Cardiovascular Health and Department of Epidemiology, Tulane School of Public Health & Tropical Medicine, New Orleans, Louisiana, USA.
Am J Hypertens. 2002 Dec;15(12):1036-41. doi: 10.1016/s0895-7061(02)03066-2.
Microalbuminuria is considered as a strong predictor of cardiovascular diseases. However, limited information is available for childhood blood pressure (BP) levels and microalbuminuria in adulthood.
This study examined 2,122 individuals enrolled in the Bogalusa Heart Study as children, aged 5 to 17 years, and as adults, aged 20 to 37 years, with an average follow-up period of 16 years. Microalbuminuria is defined as urinary albumin (in milligrams per liter) to creatinine (mmoles per liter) ratio at or above the 90th percentile specific for age, ethnicity, and sex or urinary albumin levels >/=30 mg/L.
As children, African American boys had higher BP than white boys. As adults, African Americans had higher BP and urinary albumin/creatinine ratio than whites. After adjusting for age, sex, and body mass index (BMI), African Americans with microalbuminuria in adulthood by either measure had higher systolic (P =.03) and diastolic (P =.02) BP as adults, and higher diastolic (P <.01) as children than those without this condition. On the other hand, whites showed no such significant association. In a multivariate regression analysis, adjusting for sex, childhood BMI, and age, and current smoking status, childhood BP and rate of change in BP from childhood to adulthood were significant predictors of increased urine albumin excretion in African Americans, but not in whites.
Elevated BP beginning in childhood is associated with microalbuminuria in adulthood in African Americans, but not in whites, suggesting that African Americans may be more susceptible than whites to BP-related renal damage.
微量白蛋白尿被认为是心血管疾病的有力预测指标。然而，关于儿童血压水平与成年期微量白蛋白尿的信息有限。
本研究对2122名曾参与博加卢萨心脏研究的个体进行了调查，这些个体儿童时期年龄在5至17岁，成年后年龄在20至37岁，平均随访期为16年。微量白蛋白尿的定义为尿白蛋白（毫克/升）与肌酐（毫摩尔/升）的比值达到或高于根据年龄、种族和性别确定的第90百分位数，或尿白蛋白水平≥30毫克/升。
儿童时期，非裔美国男孩的血压高于白人男孩。成年后，非裔美国人的血压和尿白蛋白/肌酐比值高于白人。在调整年龄、性别和体重指数（BMI）后，无论采用哪种测量方法，成年期患有微量白蛋白尿的非裔美国人成年时的收缩压（P = 0.03）和舒张压（P = 0.02）更高，儿童时期的舒张压（P < 0.01）也高于未患此病者。另一方面，白人则没有这种显著关联。在多变量回归分析中，调整性别、儿童BMI、年龄和当前吸烟状况后，儿童血压以及从儿童到成年期血压的变化率是非裔美国人尿白蛋白排泄增加的显著预测因素，但白人并非如此。
儿童时期开始的血压升高与非裔美国人成年期的微量白蛋白尿有关，但与白人无关，这表明非裔美国人可能比白人更容易受到与血压相关的肾脏损害。
