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微量白蛋白尿与动脉僵硬度和血管炎症独立相关,但与新诊断的 2 型糖尿病或原发性高血压患者的颈动脉内膜中层厚度无关。

Microalbuminuria is independently associated with arterial stiffness and vascular inflammation but not with carotid intima-media thickness in patients with newly diagnosed type 2 diabetes or essential hypertension.

机构信息

Department of Internal Medicine, The Catholic University of Korea, Incheon, Korea.

出版信息

J Korean Med Sci. 2013 Feb;28(2):252-60. doi: 10.3346/jkms.2013.28.2.252. Epub 2013 Jan 29.

Abstract

The association between microalbuminuria (MAU) and the indices of macrovascular complication in patients with newly diagnosed type 2 diabetes (D) or essential hypertension (H) was evaluated. Total 446 patients were classified into four groups according to the urinary albumin-to-creatinine ratio: MAU-D (n = 104), normoalbuminuria (NAU)-D (n = 114), MAU-H (n = 116), and NAU-H (n = 112). The indices of macrovascular complication including arterial stiffness evaluated by pulse-wave-velocity (PWV), carotid intima-media thickness (IMT), and vascular inflammation marked by high-sensitivity C-reactive protein (hsCRP) were assessed. PWV, IMT, and hsCRP were higher in patients with MAU than in those with NAU in both diabetes and hypertension groups. In both MAU-D and MAU-H groups, PWV and hsCRP levels were positively correlated with MAU level (MAU-D: r = 0.47, 0.41, MAU-H: r = 0.36, 0.62, respectively, P < 0.05). Additionally, PWV and hsCRP were independent factors predicting MAU (diabetes group: OR 1.85, 1.54, hypertension group: OR 1.38, 1.51, respectively, P < 0.001), but not IMT. MAU is independently associated with arterial stiffness and vascular inflammation but not with IMT in patients with newly diagnosed type 2 diabetes or essential hypertension, which emphasizes the importance of proactive clinical investigations for atherosclerotic complications in patients with MAU, even in newly diagnosed diabetes or hypertension.

摘要

评估了新诊断的 2 型糖尿病(D)或原发性高血压(H)患者中微量白蛋白尿(MAU)与大血管并发症指标之间的关系。根据尿白蛋白与肌酐比值,将 446 例患者分为四组:MAU-D(n=104)、正常白蛋白尿(NAU)-D(n=114)、MAU-H(n=116)和 NAU-H(n=112)。评估了大血管并发症的指标,包括通过脉搏波速度(PWV)评估的动脉僵硬度、颈动脉内膜中层厚度(IMT)和高敏 C 反应蛋白(hsCRP)标记的血管炎症。在糖尿病和高血压组中,MAU 患者的 PWV、IMT 和 hsCRP 均高于 NAU 患者。在 MAU-D 和 MAU-H 组中,PWV 和 hsCRP 水平与 MAU 水平呈正相关(MAU-D:r=0.47,0.41;MAU-H:r=0.36,0.62,分别,P<0.05)。此外,PWV 和 hsCRP 是预测 MAU 的独立因素(糖尿病组:OR 1.85,1.54;高血压组:OR 1.38,1.51,分别,P<0.001),但 IMT 不是。MAU 与新诊断的 2 型糖尿病或原发性高血压患者的动脉僵硬和血管炎症独立相关,但与 IMT 无关,这强调了对 MAU 患者进行动脉粥样硬化并发症的积极临床检查的重要性,即使是在新诊断的糖尿病或高血压患者中也是如此。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e4d/3565137/2b596619fda3/jkms-28-252-g001.jpg

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