Department of Family Medicine, China Medical University Hospital, and Department of Family Medicine, China Medical University, Taichung, Taiwan.
Atherosclerosis. 2010 Jul;211(1):315-21. doi: 10.1016/j.atherosclerosis.2010.02.015. Epub 2010 Feb 23.
Albuminuria is recognized as a marker of vascular dysfunction. Brachial-ankle pulse wave velocity (baPWV) reflects the stiffness of central and peripheral muscular arteries. Limited information is available for the association between albuminuria and arterial stiffness in Chinese. We aimed to assess the association between albuminuria and arterial stiffness in a middle-aged population-based study.
A total of 2180 subjects aged 40 years and over were recruited in 2004 in Taiwan. Albuminuria was defined as urinary albumin-to-creatinine ratio (ACR)>or=30 mg/g creatinine. BaPWV was divided by quartile. Multiple logistic and linear regression analyses were used to evaluate the relationship between baPWV and albuminuria.
After adjusting for age, body mass index, mean arterial pressure, fasting glucose, triglycerides, total cholesterol, chronic kidney disease, smoking, alcohol drinking, and physical activity status, multiple logistic regression analyses revealed baPWV groups were significantly associated with albuminuria. Compared to the lowest baPWV quartile, the adjusted odds ratio of having albuminuria for baPWV quartile II, III, and IV were 1.12(0.63-2.02), 2.04(1.15-3.60), and 2.45(1.29-4.65). The significant increase in odds ratios for albuminuria in progressive baPWV quartiles reveals a dose-response effect (p<0.001). Among diabetic, hypertensive, and macroalbuminuria subjects, these relationships were stronger than in subjects without diabetes, hypertension, and microalbuminuria. Moreover, multiple linear regression analyses showed that baPWV was significantly associated with urinary ACR after adjusting for potential confounders.
Albuminuria was strongly related to arterial stiffness among Chinese middle-aged adults. These relationships were enhanced in subjects with hypertension, diabetes, or macroalbuminuria.
蛋白尿被认为是血管功能障碍的标志物。肱踝脉搏波速度（baPWV）反映了中央和外周肌肉动脉的僵硬程度。在中国，关于蛋白尿与动脉僵硬之间的关联的信息有限。我们旨在评估中年人群中蛋白尿与动脉僵硬之间的关联。
2004 年，我们在台湾共招募了 2180 名年龄在 40 岁及以上的受试者。蛋白尿定义为尿白蛋白与肌酐比值（ACR）≥30mg/g 肌酐。baPWV 按四分位法进行划分。使用多变量逻辑回归和线性回归分析来评估 baPWV 与蛋白尿之间的关系。
在校正年龄、体重指数、平均动脉压、空腹血糖、甘油三酯、总胆固醇、慢性肾脏病、吸烟、饮酒和身体活动状态后，多变量逻辑回归分析显示 baPWV 组与蛋白尿显著相关。与最低 baPWV 四分位组相比，baPWV 四分位二、三、四分位组发生蛋白尿的校正比值比分别为 1.12（0.63-2.02）、2.04（1.15-3.60）和 2.45（1.29-4.65）。随着 baPWV 四分位的逐渐升高，蛋白尿的比值比显著增加，呈现出剂量-反应关系（p<0.001）。在糖尿病、高血压和大量蛋白尿患者中，这些关系强于无糖尿病、高血压和微量白蛋白尿的患者。此外，多元线性回归分析显示，在调整了潜在混杂因素后，baPWV 与尿 ACR 显著相关。
在中国中年成年人中，蛋白尿与动脉僵硬密切相关。这些关系在高血压、糖尿病或大量蛋白尿患者中增强。
