Monfared Ali, Salari Arsalan, Mirbolok Fardin, Momeni Maryam, Shafighnia Shora, Shakiba Maryam, Sheikholeslami Amir
Urology Research Center, Department of Nephrology, Guilan University of Medical Sciences, Razi Hospital, Rasht, Iran.
Iran J Kidney Dis. 2013 May;7(3):192-7.
Microalbuminuria and left ventricular hypertrophy (LVH) have both been shown to predict increased cardiovascular morbidity and mortality, especially in diabetic patients. The present study investigated the relationship between microalbuminuria and LVH in patients with essential hypertension.
After a primary workup to rule out secondary hypertension, 110 essential hypertensive patients with LVH (mean age, 62.97 ± 11.02 years) and 10 essential hypertensive patients without LVH (mean age, 65.13 ± 10.15 years) were enrolled in this case-control study. Spot urine sample was collected for the assessment of microalbuminuria and creatinine concentrations in the two groups. Smoking status, blood pressure, and serum levels of total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and creatinine were evaluated.
Patients with LVH had significantly higher microalbuminuria level compared with those without LVH (mean urine albumin-creatinine ratio, 54.4 ± 39.48 μg/mg versus 33.56 ± 21.73 μg/mg; P < .001). Multivariable regression analysis showed that the patients with a higher urine albumin-creatinine ratio were more likely to have LVH (OR, 1.028; 95% CI, 1.015 to 1.041; P < .001). Other significant predictive factors for LVH in the model were diastolic blood pressure, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and serum creatinine.
Left ventricular hypertrophy is associated with microalbuminuria in patients with essential hypertension. These data are strengthening the role of microalbuminuria as an indicator of high cardiovascular risk.
微量白蛋白尿和左心室肥厚（LVH）均已被证明可预测心血管疾病发病率和死亡率的增加，尤其是在糖尿病患者中。本研究调查了原发性高血压患者中微量白蛋白尿与LVH之间的关系。
在进行初步检查以排除继发性高血压后，110例患有LVH的原发性高血压患者（平均年龄62.97±11.02岁）和10例无LVH的原发性高血压患者（平均年龄65.13±10.15岁）被纳入本病例对照研究。收集两组的随机尿样以评估微量白蛋白尿和肌酐浓度。评估吸烟状况、血压以及总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇和肌酐的血清水平。
与无LVH的患者相比，患有LVH患者的微量白蛋白尿水平显著更高（平均尿白蛋白肌酐比值，54.4±39.48μg/mg对33.56±21.73μg/mg；P<.001）。多变量回归分析显示，尿白蛋白肌酐比值较高的患者更有可能患有LVH（比值比，1.（此处疑似有误，原文为1.028）；95%可信区间，1.015至1.041；P<.001）。该模型中LVH的其他显著预测因素为舒张压、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇和血清肌酐。
原发性高血压患者的左心室肥厚与微量白蛋白尿相关。这些数据强化了微量白蛋白尿作为高心血管风险指标的作用。
