Yan Liuxia, Ma Jixiang, Guo Xiaolei, Tang Junli, Zhang Jiyu, Lu Zilong, Wang Huicheng, Cai Xiaoning, Wang Linhong
National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
BMC Nephrol. 2014 Oct 13;15:165. doi: 10.1186/1471-2369-15-165.
Microalbuminuria has been shown to be a risk factor for cardiovascular and renal disease in patients with hypertension and diabetes as well as in the general population. Urinary albumin excretion over 24 h is considered a 'gold standard' to detect microalbuminuria. Few studies have used 24-h urinary albumin excretion to analyze the prevalence of and related factors for microalbuminuira in a general Chinese population.
This study included 1980 adults aged 18-69 years from the Shandong-Ministry of Health Action on Salt and Hypertension (SMASH) Project 2011 survey. Blood pressure, height, weight and waist circumference were measured, and a venous blood and timed 24-h urine samples were collected from each participant. Linear and logistic regression analyses were used to test associations between established cardiovascular risk factors and microalbuminuria.
The median (25th-75th percentile) of 24-h urinary albumin excretion was 6.1 mg/d (4.5-8.7 mg/d) for all adults, 6.0 mg/d (4.4-8.5 mg/d) for men and 6.2 mg/d (4.6-8.9 mg/d) for women. The overall prevalence of microalbuminuria was 4.1% (95% confidence interval [CI]: 3.2-5.0%), 3.7% (95% CI: 2.9-4.5%) for men and 4.6% (95% CI: 3.7-5.5%) for women. Microalbuminuria was present in 8.1% (95% CI: 6.9-9.3%) of individuals with hypertension, 11.4% (95% CI: 10.0-12.8%) of those with diabetes and 15.6% (95% CI: 14.0-17.2%) of those with both. Multiple logistic regression analysis indicated that systolic blood pressure (odds ratio [OR] 1.02; 95% CI: 1.01-1.03) and fasting blood glucose (OR 1.19; 95% CI: 1.05-1.35) were the independent risk factors for microalbuminuria.
Adults in the general population of Shandong Province have a moderate prevalence of microalbuminuria. Those with hypertension and diabetes are at high risk of having microalbuminuria, suggesting the need for screening and early intervention for microalbuminuria among these individuals.
微量白蛋白尿已被证明是高血压和糖尿病患者以及普通人群中心血管疾病和肾脏疾病的危险因素。24小时尿白蛋白排泄量被认为是检测微量白蛋白尿的“金标准”。很少有研究使用24小时尿白蛋白排泄量来分析中国普通人群中微量白蛋白尿的患病率及相关因素。
本研究纳入了来自2011年山东-卫生部盐与高血压行动（SMASH）项目调查的1980名年龄在18至69岁之间的成年人。测量了血压、身高、体重和腰围，并从每位参与者采集了静脉血和定时24小时尿液样本。采用线性和逻辑回归分析来检验既定心血管危险因素与微量白蛋白尿之间的关联。
所有成年人24小时尿白蛋白排泄量的中位数（第25-75百分位数）为6.1毫克/天（4.5-8.7毫克/天），男性为6.0毫克/天（4.4-8.5毫克/天），女性为6.2毫克/天（4.6-8.9毫克/天）。微量白蛋白尿的总体患病率为4.1%（95%置信区间[CI]：3.2-5.0%），男性为3.7%（95%CI：2.9-4.5%），女性为4.6%（95%CI：3.7-5.5%）。高血压患者中微量白蛋白尿的患病率为8.1%（95%CI：6.9-9.3%），糖尿病患者中为11.4%（95%CI：10.0-12.8%），同时患有高血压和糖尿病的患者中为15.6%（95%CI：14.0-17.2%）。多因素逻辑回归分析表明，收缩压（比值比[OR]1.02；95%CI：1.01-1.03）和空腹血糖（OR 1.19；95%CI：1.05-1.35）是微量白蛋白尿的独立危险因素。
山东省普通人群中的成年人微量白蛋白尿患病率中等。高血压和糖尿病患者患微量白蛋白尿的风险较高，这表明需要对这些人群进行微量白蛋白尿的筛查和早期干预。
