Dipartimento di Medicina Interna, Malattie Cardiovascolari e Nefrourologiche, Cattedra di Medicina Interna, European Society of Hypertension Excellence Centre, Università di Palermo, Palermo, Italy.
Dipartimento di Medicina Interna, Malattie Cardiovascolari e Nefrourologiche, Cattedra di Nefrologia, European Society of Hypertension Excellence Centre, Università di Palermo, Palermo, Italy.
Int J Cardiol. 2010 Nov 19;145(2):372-375. doi: 10.1016/j.ijcard.2010.02.047. Epub 2010 Mar 12.
The aim of our study was to assess the independent relationships of urinary albumin excretion rate (AER), of creatinine clearance (CrCl) and of their interaction with aortic stiffness in hypertensive patients without overt renal insufficiency. We studied 222 untreated nondiabetic essential hypertensives. In patients with reliable 24-h urine collections, AER and CrCl were determined. Microalbuminuria (MAU) was defined as an AER of 20 to 200 µg/min. Aortic stiffness was assessed by measurement of carotid-femoral pulse wave velocity (c-f PWV). C-f PWV was higher in subjects with MAU than in those without it (p<0.001, even after adjustment for age, sex and mean arterial pressure) and in subjects with CrCl below 90 ml/min/1.73 m(2) when compared to those with greater values of CrCl (p=0.04 after correction for age, sex and mean arterial pressure). There was a significant interaction of MAU and reduced CrCl regarding c-f PWV (p=0.04). In multiple regression analysis, AER and CrCl remained independently associated with aortic stiffness (β=0.22; p<0.001 and β=-0.13; p=0.02, respectively). In essential hypertensive patients microalbuminuria and mildly reduced CrCl are related independently of each other with increased c-f PWV and exert a synergistic unfavourable effect on aortic stiffness.
我们的研究目的是评估尿白蛋白排泄率（AER）、肌酐清除率（CrCl）及其与主动脉僵硬的独立关系，这些在没有明显肾功能不全的高血压患者中。我们研究了 222 名未经治疗的非糖尿病原发性高血压患者。在有可靠 24 小时尿液收集的患者中，测定 AER 和 CrCl。微量白蛋白尿（MAU）定义为 AER 为 20 至 200μg/min。通过测量颈动脉-股动脉脉搏波速度（c-f PWV）来评估主动脉僵硬。与无 MAU 的患者相比，MAU 患者的 c-f PWV 更高（p<0.001，即使在调整年龄、性别和平均动脉压后），CrCl 低于 90ml/min/1.73m(2)的患者与 CrCl 值较高的患者相比（在调整年龄、性别和平均动脉压后，p=0.04）。MAU 和 CrCl 减少对 c-f PWV 的交互作用有显著意义（p=0.04）。在多元回归分析中，AER 和 CrCl 与主动脉僵硬独立相关（β=0.22；p<0.001 和 β=-0.13；p=0.02）。在原发性高血压患者中，微量白蛋白尿和轻度 CrCl 降低与 c-f PWV 增加独立相关，并对主动脉僵硬产生协同的不利影响。
