Medical University of Havana and Nephrology Institute, Havana, Cuba.
MEDICC Rev. 2010 Oct;12(4):20-6. doi: 10.37757/MR2010.V12.N4.5.
The disease complex comprised of atherosclerosis, chronic kidney disease (CKD) and other associated chronic vascular diseases is the leading cause of mortality worldwide. Microalbuminuria is a marker for vascular damage in the heart, kidney and brain. This paper presents selected findings of the clinical-epidemiological Isle of Youth Study (ISYS) of markers for kidney and vascular damage from chronic vascular diseases and their common risk factors in total population, focusing on Phase 2 reassessment (in 2010) of Phase 1 (2004 to 2006) results.
(1) Update the prevalence of risk factors in the study population aged ≥20 years (adult population). (2) Confirm presence of microalbuminuria in at-risk adults diagnosed as presumptive positives in Phase I. (3) Evaluate association between microalbuminuria and selected risk factors.
Of 3779 adults positive for microalbuminuria in ISYS Phase 1, 73.1% were reevaluated. The risk-factor questionnaire was re-administered and blood pressure, weight and height were measured. Blood was tested for creatinine, glycemia, cholesterol and triglycerides. Glomerular filtration rate was calculated using the Modification of Diet in Renal Disease (MDRD) formula. Albuminuria was measured in urine using Micral-Test (Germany) and albumin/creatinine ratio (ACR) by nephelometry. This paper uses ACR as the reference for analyzing risk factor associations. Double-entry tables were developed to analyze association among microalbuminuria, risk factors and co-morbidities.
Most prevalent risks were hypertension, consumption of nonsteroidal anti-inflammatory drugs (NSAIDs), excess weight and hypertriglyceridemia. Microalbuminuria was confirmed in 18% of cases, using the same test. Elevated prevalence of microalbuminuria was positively associated with advancing age, male sex, underweight, smoking, NSAID use, dyslipidemia, hypertension, diabetes, heart disease and stroke.
The at-risk cohort studied presented low levels of confirmation for positive microalbuminuria. Positive microalbuminuria stratified individuals at greatest risk, except for obesity.
由动脉粥样硬化、慢性肾脏病 (CKD) 和其他相关慢性血管疾病组成的疾病谱是全球死亡的主要原因。微量白蛋白尿是心脏、肾脏和大脑血管损伤的标志物。本文介绍了古巴青年岛临床流行病学研究 (ISYS) 的部分研究结果，该研究使用了慢性血管疾病及其共同危险因素的标志物，重点关注 2010 年对 2004 年至 2006 年第一阶段 (ISYS1) 的重新评估。
(1) 更新≥20 岁研究人群中危险因素的流行情况（成年人群）。(2) 确认在 ISYS1 中被诊断为疑似阳性的高危成年人存在微量白蛋白尿。(3) 评估微量白蛋白尿与选定危险因素之间的关系。
在 ISYS1 中，3779 名成年人的微量白蛋白尿呈阳性，其中 73.1%接受了重新评估。重新进行了危险因素问卷调查，并测量了血压、体重和身高。采集血液用于检测肌酐、血糖、胆固醇和甘油三酯。肾小球滤过率采用肾脏病膳食改良公式 (MDRD) 进行计算。尿液中的白蛋白采用 Micral-Test（德国）进行检测，白蛋白/肌酐比值 (ACR) 采用比浊法进行检测。本文使用 ACR 作为分析危险因素相关性的参考。采用双录入表分析微量白蛋白尿、危险因素和共病之间的关系。
最常见的风险因素是高血压、非甾体抗炎药 (NSAIDs) 的使用、超重和高三酰甘油血症。使用相同的检测方法，18%的病例确认存在微量白蛋白尿。微量白蛋白尿的高发与年龄增长、男性、体重不足、吸烟、NSAIDs 使用、血脂异常、高血压、糖尿病、心脏病和中风呈正相关。
所研究的高危人群中，对阳性微量白蛋白尿的确认率较低。阳性微量白蛋白尿对风险最大的个体进行了分层，除肥胖外。
