贫困与蛋白尿患病率之间的关联：来自第三次全国健康和营养检查调查（NHANES III）的数据。
The association of poverty with the prevalence of albuminuria: data from the Third National Health and Nutrition Examination Survey (NHANES III).
作者信息
Martins David, Tareen Naureen, Zadshir Ashraf, Pan Deyu, Vargas Roberto, Nissenson Allen, Norris Keith
机构信息
Department of Medicine, Charles R. Drew University, Los Angeles, CA, USA.
出版信息
Am J Kidney Dis. 2006 Jun;47(6):965-71. doi: 10.1053/j.ajkd.2006.02.179.
BACKGROUND
Albuminuria is a major risk factor for the development and progression of chronic kidney disease (CKD) and cardiovascular disease. Socioeconomic factors also have been reported to modify CKD and cardiovascular risk factors and clinical outcomes. The extent to which poverty influences the prevalence of albuminuria, particularly among racial/ethnic minority populations, is not well established. The influence of poverty on the prevalence of albuminuria and the implication of this relationship for the racial and/or ethnic differences in the prevalence of albuminuria were examined.
METHODS
We examined data from 6,850 male and 7,634 female adults from a national probability survey conducted between 1988 and 1994.
RESULTS
In univariate analysis, poverty, defined as less than 200% federal poverty level (FPL), was associated with the presence of both microalbuminuria (odds ratio [OR], 1.35; 95% confidence interval, 1.22 to 1.49) and macroalbuminuria (OR, 1.78; 95% confidence interval, 1.40 to 2.26). The association of less than 200% FPL with microalbuminuria persisted in a multivariate model controlling for age, sex, race, education, obesity, hypertension, diabetes, reduced glomerular filtration rate, and medication use (OR, 1.18; 95% confidence interval, 1.05 to 1.33). FPL less than 200% was not associated with macroalbuminuria in the multivariate model. When multivariate analysis is stratified by FPL (<200% and > or =200%), differences in ORs for microalbuminuria and macroalbuminuria among racial/ethnic minority participants compared with whites were more apparent among the less affluent participants in the FPL-less-than-200% stratum.
CONCLUSION
FPL less than 200% is associated with microalbuminuria, and differences in FPL levels may account for some of the observed differences in prevalence of albuminuria between racial/ethnic minority participants and their white counterparts.
背景
蛋白尿是慢性肾脏病（CKD）和心血管疾病发生及进展的主要危险因素。据报道，社会经济因素也会改变CKD和心血管疾病的危险因素及临床结局。贫困对蛋白尿患病率的影响程度，尤其是在种族/族裔少数群体中，尚未明确。本研究探讨了贫困对蛋白尿患病率的影响以及这种关系对蛋白尿患病率种族和/或族裔差异的意义。
方法
我们分析了1988年至1994年全国概率调查中6850名男性和7634名女性成年人的数据。
结果
在单因素分析中，贫困定义为低于联邦贫困线（FPL）的200%，与微量白蛋白尿（优势比[OR]，1.35；95%置信区间，1.22至1.49）和大量白蛋白尿（OR，1.78；95%置信区间，1.40至2.26）均相关。在控制年龄、性别、种族、教育程度、肥胖、高血压、糖尿病、肾小球滤过率降低和药物使用的多因素模型中，低于FPL的200%与微量白蛋白尿的关联仍然存在（OR，1.18；95%置信区间，1.05至1.33）。在多因素模型中，低于FPL的200%与大量白蛋白尿无关。当按FPL（<200%和≥200%）进行多因素分层分析时，与白人相比，种族/族裔少数群体参与者中微量白蛋白尿和大量白蛋白尿的OR差异在FPL低于200%的较贫困参与者中更为明显。
结论
低于FPL的200%与微量白蛋白尿相关，FPL水平的差异可能是种族/族裔少数群体参与者与其白人对应者之间观察到的蛋白尿患病率差异的部分原因。
Zotero 插件