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老年社区人群尿微量白蛋白/肌酐比值与心血管危险因素的相关性

[Association between the urinary microalbumin/creatinine ratio and cardiovascular risk factors among elderly community subjects].

作者信息

Zhou Jing-min, Cui Xiao-tong, Jin Xue-juan, Zhou Jun, Ge Jun-bo

机构信息

Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai 200032, China.

出版信息

Zhonghua Xin Xue Guan Bing Za Zhi. 2011 May;39(5):463-7.

Abstract

OBJECTIVE

To determine the value of the urinary microalbumin/creatinine ratio (UACR) and the relationship between UACR and traditional cardiovascular risk factors among elderly community subjects.

METHODS

A representative population in Shanghai rural district aged more than 65 years who participated in the heart health survey of the key projects in the national science and technology pillar program in the eleventh five-year plan period of China were sampled via a clustered complex sampling method. A midstream collection from the first morning void collected was used to measure the urinary microalbumin, the urinary creatinine and the UACR. Baseline information including traditional cardiovascular risk factors were obtained by standard questionaire to analyze the distribution status of UACR in the population with or without the risk factors.

RESULTS

(1) There were 1718 subjects (721 males) of (73.3 ± 5.5) years included in this study. (2) The prevalence of with at least one cardiovascular risk factor was 78.00% in this cohort, the top there risk factors were dyslipidemia (61.06%), hypertension (44.59%) and diabetes (13.80%). (3) The median (the lower quartile-the upper quartile) of the UACR of the population without cardiovascular diseases and risk factors was 13.81 (6.03 - 26.51) µg/mg. The level of UACR was significantly higher in females than that in males [17.12 (7.28 - 33.28) µg/mg vs. 5.49 (2.92 - 9.76) µg/mg, P < 0.01]. (4) The level of UACR in population with hypertension, diabetes or dyslipidemia was 16.27 (6.65 - 42.00) µg/mg, 26.27 (10.92 - 76.65) µg/mg and 16.39 (6.98 - 41.03) µg/mg respectively, all exceeding that of the healthy group (P < 0.05 or P < 0.01). (5) The levels of UACR increased in proportion to the increase of cardiovascular risk factor numbers, the UACR of the population with 0, 1, 2, 3 and 4 cardiovascular risk factors were 13.81 (6.03 - 26.51) µg/mg, 15.76 (6.79 - 36.44) µg/mg, 13.82 (5.68 - 34.43) µg/mg, 16.47 (6.07 - 50.56) µg/mg and 18.63 (11.26 - 83.09) µg/mg, respectively. The population with 4 cluster of cardiovascular risk factors posed the higher level of UACR than that of population with 0 cardiovascular risk factors (P < 0.05).

CONCLUSIONS

The three most common risk factors of cardiovascular diseases among the elderly community subjects aged more than 65 years are dyslipidemia, hypertension and diabetes, all of which are related to the elevation of UACR.

摘要

目的

确定尿微量白蛋白/肌酐比值(UACR)在老年社区人群中的价值,以及UACR与传统心血管危险因素之间的关系。

方法

采用整群抽样方法,对上海市农村地区65岁以上参与“十一五”国家科技支撑计划重点项目心脏健康调查的具有代表性人群进行抽样。收集首次晨尿中段尿,检测尿微量白蛋白、尿肌酐及UACR。通过标准问卷获取包括传统心血管危险因素在内的基线信息,分析有无危险因素人群中UACR的分布情况。

结果

(1)本研究共纳入1718名受试者(721名男性),年龄为(73.3±5.5)岁。(2)该队列中至少有一种心血管危险因素的患病率为78.00%,前三位危险因素为血脂异常(61.06%)、高血压(44.59%)和糖尿病(13.80%)。(3)无心血管疾病及危险因素人群的UACR中位数(下四分位数 - 上四分位数)为13.81(6.03 - 26.51)μg/mg。女性UACR水平显著高于男性[17.12(7.28 - 33.28)μg/mg vs. 5.49(2.92 - 9.76)μg/mg,P < 0.01]。(4)高血压、糖尿病或血脂异常人群的UACR水平分别为16.27(6.65 - 42.00)μg/mg、26.27(10.92 - 76.65)μg/mg和16.39(6.98 - 41.03)μg/mg,均高于健康组(P < 0.05或P < 0.01)。(5)UACR水平随心血管危险因素数量的增加而升高,无、1、2、3和4种心血管危险因素人群的UACR分别为13.81(6.03 - 26.51)μg/mg、15.76(6.79 - 36.44)μg/mg、13.82(5.68 - 34.43)μg/mg、16.47(6.07 - 50.56)μg/mg和18.63(11.26 - 83.09)μg/mg。有4种心血管危险因素聚集的人群UACR水平高于无心血管危险因素的人群(P < 0.05)。

结论

65岁以上老年社区人群中,心血管疾病最常见的三种危险因素为血脂异常、高血压和糖尿病,均与UACR升高有关。

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