Department of Endocrinology, Chinese PLA General Hospital, Beijing, China.
Scand J Clin Lab Invest. 2012 Jul;72(4):281-6. doi: 10.3109/00365513.2012.661071. Epub 2012 Mar 5.
To investigate the relationship between albuminuria and mortality in a middle-aged-to-elderly Chinese population.
A total of 2,344 individuals aged over 40 in the same district were interviewed and followed up for 4 years. Information on survival or cause of death was recorded. A total of 2,181 participants with detailed information were finally recruited. Baseline overnight urine samples were obtained to measure urinary albumin and creatinine. The urinary albumin excretion rate was expressed as albumin-to-creatinine ratio (ACR). Participants were divided into three groups, according to their ACR: normoalbuminuria (ACR < 30 mg/g), microalbuminuria (≥ 30 - < 300 mg/g ACR) and macroalbuminuria (ACR ≥ 300 mg/g). The Cox proportional hazard model was used to analyze the relationships between albuminuria and cardiovascular and all-cause mortalities.
Seventy-seven deaths with known causes were registered. The prevalences of microalbuminuria and macroalbuminuria at baseline were 8.3% and 1.6%, respectively. Cardiovascular mortalities in the normoalbuminuria, microalbuminuria and macroalbuminuria groups were 2.4, 11.0, and 36.8/1,000 person years (pyrs) respectively, and all-cause mortalities were 6.9, 20.6, and 58.8/1,000 pyrs. After adjusting for confounding factors, the relative risks (RR) of cardiovascular mortality were 2.72 (95% CI, 1.06-4.20) in the microalbuminuria group, and 4.87 (95% CI, 2.46-9.45) in the macroalbuminuria group. Adjusted RRs for all-cause mortality were 2.01 (95% CI, 0.96-4.77) and 3.76 (95% CI, 1.52-7.15) in the two groups, respectively.
Albuminuria is a useful predictor of cardiovascular mortality and all-cause mortality in the general population.
探讨白蛋白尿与中年及老年中国人死亡率之间的关系。
对同一地区 2344 名 40 岁以上的个体进行访谈和 4 年随访。记录生存或死亡原因的信息。最终共纳入 2181 名有详细资料的参与者。采集基线过夜尿样以测量尿白蛋白和肌酐。尿白蛋白排泄率用白蛋白/肌酐比值（ACR）表示。根据 ACR 将参与者分为三组：正常白蛋白尿组（ACR＜30mg/g）、微量白蛋白尿组（30-＜300mg/g ACR）和大量白蛋白尿组（ACR≥300mg/g）。采用 Cox 比例风险模型分析白蛋白尿与心血管和全因死亡率之间的关系。
共登记 77 例死因明确的死亡病例。基线时微量白蛋白尿和大量白蛋白尿的患病率分别为 8.3%和 1.6%。正常白蛋白尿、微量白蛋白尿和大量白蛋白尿组的心血管死亡率分别为 2.4、11.0 和 36.8/1000 人年（pyrs），全因死亡率分别为 6.9、20.6 和 58.8/1000 pyrs。校正混杂因素后，微量白蛋白尿组心血管死亡率的相对风险（RR）为 2.72（95%可信区间，1.06-4.20），大量白蛋白尿组为 4.87（95%可信区间，2.46-9.45）。校正后的全因死亡率 RR 分别为 2.01（95%可信区间，0.96-4.77）和 3.76（95%可信区间，1.52-7.15）。
白蛋白尿是一般人群心血管死亡率和全因死亡率的有用预测指标。
