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红细胞分布宽度与微量白蛋白尿的关系:一项基于多民族代表性美国成年人的人群研究。

Relationship between red cell distribution width and microalbuminuria: a population-based study of multiethnic representative US adults.

机构信息

Division of Cardiology, Wayne State University, Detroit Medical Center, Detroit, MI 48201, USA.

出版信息

Nephron Clin Pract. 2011;119(4):c277-82. doi: 10.1159/000328918.

Abstract

INTRODUCTION

Microalbuminuria (MA), a renal marker of vascular injury, is an independent predictor of cardiovascular (CV) events. Red cell distribution width (RDW), an emerging CV risk predictor, has not been evaluated for its association with MA.

METHODS

We evaluated 8,499 participants of the National Health and Nutrition Examination Survey (NHANES) 1999-2006, where RDW was evaluated as a continuous variable and in quartiles (Q(1) ≤ 12.1, Q(2) 12.2-12.5, Q(3) 12.6-13 and Q(4) >13). Multivariate adjusted logistic regression analysis was performed to estimate the odds of having MA (n = 1,736; adjusted for traditional CV risk factors, race, BMI, estimated glomerular filtration rate, hemoglobin, mean corpuscular volume, high-sensitivity C-reactive protein and nutritional factors deficiencies of iron, folate and vitamin B(12)).

RESULTS

The prevalence of MA increased with increasing RDW (13.52% in Q(1) vs. 30.02% in Q(4), p < 0.001). The odds of having MA for those in Q(4) was 2.49 (95% CI: 1.95-3.18, p < 0.001) compared to those in Q(1) after the adjustments. No effect modification was observed by covariates on the association between RDW and MA.

CONCLUSION

Elevated RDW is independently associated with a higher risk of MA. An interaction between chronic inflammation, oxidative stress, neurohumoral overactivity and endothelial dysfunction may explain this association and the attendant elevated CV/renal risk.

摘要

简介

微量白蛋白尿 (MA) 是血管损伤的肾脏标志物,是心血管 (CV) 事件的独立预测因子。红细胞分布宽度 (RDW) 是一种新兴的 CV 风险预测因子,尚未评估其与 MA 的相关性。

方法

我们评估了 1999 年至 2006 年全国健康和营养调查 (NHANES) 的 8499 名参与者,其中 RDW 被评估为连续变量和四分位间距 (Q(1) ≤ 12.1、Q(2) 12.2-12.5、Q(3) 12.6-13 和 Q(4) >13)。进行多变量调整后的逻辑回归分析,以估计 MA(n = 1736;调整了传统的 CV 危险因素、种族、BMI、估计肾小球滤过率、血红蛋白、平均红细胞体积、高敏 C 反应蛋白和营养因素缺铁、叶酸和维生素 B(12) 缺乏)的几率。

结果

MA 的患病率随 RDW 的增加而增加(Q(1)为 13.52%,Q(4)为 30.02%,p <0.001)。与 Q(1)相比,Q(4)的 MA 发生率为 2.49(95%CI:1.95-3.18,p <0.001),调整后。协变量对 RDW 与 MA 之间的关联没有观察到效应修饰。

结论

升高的 RDW 与 MA 的风险增加独立相关。慢性炎症、氧化应激、神经体液过度活跃和内皮功能障碍之间的相互作用可能解释这种关联以及随之而来的升高的 CV/肾脏风险。

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