Tsioufis Costas, Dimitriadis Kyriakos, Chatzis Dimitris, Vasiliadou Carmen, Tousoulis Dimitrios, Papademetriou Vasilios, Toutouzas Pavlos, Stefanadis Christodoulos, Kallikazaros Ioannis
Department of Cardiology, Hippokration Hospital, Athens, Greece.
Am J Cardiol. 2005 Oct 1;96(7):946-51. doi: 10.1016/j.amjcard.2005.05.052.
Microalbuminuria, and recently, hypoadiponectinemia, have been associated with progression of atherosclerotic disease and increased cardiovascular risk. We examined the possible associations of urinary albumin excretion, expressed as the ratio of albumin to creatinine (ACR), with plasma adiponectin and high-sensitivity C-reactive protein (hs-CRP) levels in men who had essential hypertension. The study population consisted of 108 men who did not have diabetes and were newly diagnosed with stage I to II essential hypertension (age 44.6 years, office blood pressure 148/95 mm Hg) and 110 men matched according to age and body mass index as controls. According to ACR values, which were determined as the average of 2 nonconsecutive overnight spot urine samples, subjects who had hypertension were categorized into 2 groups: those who had microalbuminuria (n = 28; mean ACR 30 to 300 mg/g) and those who had normal albuminuria (n = 80; mean ACR <30 mg/g). Subjects who had hypertension compared with controls exhibited higher ACR and log hs-CRP levels and a trend toward lower log adiponectin values (p = 0.062), whereas those who had normal albuminuria compared with controls had similar log adiponectin levels but significantly higher levels of ACR and log hs-CRP. Moreover, subjects who had hypertension and microalbuminuria compared with those who had hypertension and normal albuminuria had higher log hs-CRP and lower log adiponectin concentrations independently of confounding factors. Among those who had hypertension, ACR exhibited an independent positive correlation with log hs-CRP and a negative correlation with log adiponectin. Multiple linear regression analysis showed that age, body mass index, systolic blood pressure, log hs-CRP, and log adiponectin were significant independent predictors of the ACR. In conclusion, microalbuminuria is accompanied by decreased adiponectin and increased hs-CRP levels in the setting of essential hypertension, reflecting a rather diffuse atherosclerotic process.
微量白蛋白尿，以及最近发现的低脂联素血症，都与动脉粥样硬化疾病的进展和心血管风险增加有关。我们研究了以白蛋白与肌酐比值（ACR）表示的尿白蛋白排泄量与原发性高血压男性患者血浆脂联素和高敏C反应蛋白（hs-CRP）水平之间的可能关联。研究人群包括108名无糖尿病且新诊断为I至II期原发性高血压的男性（年龄44.6岁，诊室血压148/95 mmHg）以及110名根据年龄和体重指数匹配的男性作为对照。根据ACR值（通过2次非连续的夜间随机尿样平均值确定），高血压患者被分为2组：微量白蛋白尿组（n = 28；平均ACR 30至300 mg/g）和正常白蛋白尿组（n = 80；平均ACR <30 mg/g）。与对照组相比，高血压患者的ACR和hs-CRP对数水平更高，且脂联素对数水平有降低趋势（p = 0.062），而正常白蛋白尿组与对照组相比，脂联素对数水平相似，但ACR和hs-CRP对数水平显著更高。此外，与高血压且白蛋白尿正常的患者相比，高血压且微量白蛋白尿的患者在不考虑混杂因素的情况下，hs-CRP对数水平更高，脂联素对数浓度更低。在高血压患者中，ACR与hs-CRP对数呈独立正相关，与脂联素对数呈负相关。多元线性回归分析表明，年龄、体重指数、收缩压、hs-CRP对数和脂联素对数是ACR的重要独立预测因素。总之，在原发性高血压情况下，微量白蛋白尿伴随着脂联素降低和hs-CRP水平升高，反映了一个较为广泛的动脉粥样硬化过程。
