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尿白蛋白排泄反映无糖尿病绝经后女性的心血管风险:2011至2013年韩国国民健康与营养检查调查

Urinary Albumin Excretion Reflects Cardiovascular Risk in Postmenopausal Women without Diabetes: The 2011 to 2013 Korean National Health and Nutrition Examination Survey.

作者信息

Ahn Hee Jung, Moon Do Sik, Kang Da Yeong, Lee Jung In, Kim Da Young, Kim Jin Hwa, Kim Sang Yong, Bae Hak Yeon

机构信息

Division of Endocrinology and Metabolism, Department of Internal Medicine, Chosun University Hospital, Chosun University School of Medicine, Gwangju, Korea.

出版信息

Endocrinol Metab (Seoul). 2016 Dec;31(4):537-546. doi: 10.3803/EnM.2016.31.4.537. Epub 2016 Nov 3.

Abstract

BACKGROUND

The objective of the current study was to determine whether there was an association between urinary albumin excretion and cardiovascular disease (CVD) risk by estimating the Framingham Risk Score (FRS) in postmenopausal women without diabetes.

METHODS

This study was based on data from the Korea National Health and Nutrition Examination Survey, which was conducted by the Korean Ministry of Health and Welfare in 2011 to 2013. Data on 2,316 postmenopausal women from a total of 24,594 participants was included in the analysis.

RESULTS

The mean FRS was significantly different in each of the urinary albumin to creatinine ratio (UACR) subgroups, and it increased with UACR. The FRS was 12.69±0.12 in the optimal group, 14.30±0.19 in the intermediate normal group, 14.62±0.26 in the high normal group, and 15.86±0.36 in the microalbuminuria group. After fully adjusting for potential confounding factors, high normal levels and microalbuminuria were significantly associated with the highest tertile of FRS ([odds ratio (OR), 1.642; 95% confidence interval (CI), 1.124 to 2.400] and [OR, 3.385; 95% CI, 2.088 to 5.488], respectively) compared with the optimal subgroup. High normal levels and microalbuminuria were also significantly associated with a ≥10% 10-year risk of CVD ([OR, 1.853; 95% CI, 1.122 to 3.060] and [OR, 2.831; 95% CI, 1.327 to 6.037], respectively) after adjusting for potential confounding covariates.

CONCLUSION

Urinary albumin excretion reflects CVD risk in postmenopausal women without diabetes, and high normal levels and microalbuminuria were independently associated with a higher risk of CVD.

摘要

背景

本研究的目的是通过估算无糖尿病绝经后女性的弗明汉风险评分(FRS),来确定尿白蛋白排泄与心血管疾病(CVD)风险之间是否存在关联。

方法

本研究基于韩国国家健康与营养检查调查的数据,该调查由韩国卫生与福利部于2011年至2013年进行。分析纳入了总共24,594名参与者中的2,316名绝经后女性的数据。

结果

尿白蛋白与肌酐比值(UACR)各亚组的平均FRS存在显著差异,且随UACR升高而增加。最佳组的FRS为12.69±0.12,中正常组为14.30±0.19,高正常组为14.62±0.26,微量白蛋白尿组为15.86±0.36。在对潜在混杂因素进行充分校正后,与最佳亚组相比,高正常水平和微量白蛋白尿与FRS最高三分位数显著相关([比值比(OR),1.642;95%置信区间(CI),1.124至2.400]和[OR,3.385;95%CI,2.088至5.488])。在对潜在混杂协变量进行校正后,高正常水平和微量白蛋白尿也与CVD的10年风险≥10%显著相关([OR,1.853;95%CI,1.122至3.060]和[OR,2.831;95%CI,1.327至6.037])。

结论

尿白蛋白排泄反映了无糖尿病绝经后女性的CVD风险,高正常水平和微量白蛋白尿与更高的CVD风险独立相关。

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