Xiao Wenkai, Ye Ping, Cao Ruihua, Yang Xu, Bai Yongyi, Wu Hongmei
Department of Geriatric Cardiology, Chinese PLA General Hospital, No. 28, Fuxing Road, Beijing, 100853, China.
PLoS One. 2015 Aug 24;10(8):e0135747. doi: 10.1371/journal.pone.0135747. eCollection 2015.
Urine albumin excretion is an important predictor of adverse cardiovascular events. Minimally elevated levels of serum cardiac troponin T (cTnT), a marker of cardiomyocyte micronecrosis, can be detected with high sensitivity cTnT (hs-cTnT) assays. The purpose of this study was to investigate the relationship between alterations in albuminuria and serum hs-cTnT levels in a community-based population.
We examined the association between the urine albumin/creatinine ratio (UACR) and hs-cTnT levels in 1354 participants without overt cardiovascular disease in a community-based, cross-sectional study in Beijing, China.
With the highly sensitive assay, cTnT levels were detectable in 90.5% of our subjects. The median (interquartile range) concentrations of hs-cTnT were 7 (5-10) pg/mL. After adjustment for several factors, UACR (odds ratio: 1.40; 95% confidence interval: 1.08-1.65; P = 0.002) was associated with a higher likelihood of elevated hs-cTnT (≥14 pg/ mL), whereas the relationship between UACR and a higher presence of detectable hs-cTnT (≥ 3 pg/ mL) was not significant. In addition, a fully adjusted logistic regression analysis revealed that compared with participants in the lowest UACR quartile, those in the highest quartile had a 2.43- fold (95% CI: 1.25-5.08; P = 0.006) increased risk of elevated hs-cTnT.
Higher urine albumin excretion is associated with elevated hs-cTnT among persons without clinically evident cardiovascular disease, suggesting that albuminuria may be a potential risk factor for subclinical cardiovascular disease in the general population.
尿白蛋白排泄是心血管不良事件的重要预测指标。心肌肌钙蛋白T(cTnT)是心肌细胞微坏死的标志物,采用高敏cTnT(hs-cTnT)检测法可检测到血清中微量升高的cTnT水平。本研究旨在探讨社区人群中蛋白尿变化与血清hs-cTnT水平之间的关系。
在中国北京开展的一项基于社区的横断面研究中,我们对1354名无明显心血管疾病的参与者的尿白蛋白/肌酐比值(UACR)与hs-cTnT水平之间的关联进行了研究。
采用高敏检测法,90.5%的受试者可检测到cTnT水平。hs-cTnT的中位数(四分位间距)浓度为7(5-10)pg/mL。在对多个因素进行校正后,UACR(比值比:1.40;95%置信区间:1.08-1.65;P = 0.002)与hs-cTnT升高(≥14 pg/mL)的可能性较高相关,而UACR与hs-cTnT可检测性较高(≥3 pg/mL)之间的关系并不显著。此外,一项完全校正的逻辑回归分析显示,与UACR最低四分位组的参与者相比,最高四分位组的参与者hs-cTnT升高的风险增加了2.43倍(95%CI:1.25-5.08;P = 0.006)。
在无临床明显心血管疾病的人群中,较高的尿白蛋白排泄与hs-cTnT升高相关,提示蛋白尿可能是普通人群亚临床心血管疾病的潜在危险因素。