Yang Shi-Kun, Liu Jun, Yi Bin, Mao Juan, Zhang Xian-Ming, Liu Yan, Lei Dan-Dan, Gui Ming, Zhang Hao
Department of Nephrology, Third Xiangya Hospital, Central South University, Changsha, Hunan, China.
Ther Apher Dial. 2017 Aug;21(4):387-394. doi: 10.1111/1744-9987.12530. Epub 2017 Mar 20.
Microalbuminuria is an early biomarker of kidney injury, the aim of this study was to investigate the impact of high sensitivity C-reactive protein (hs-CRP) on microalbuminuria in adults with cardiovascular disease (CVD) risk factors. A total of 5667 subjects who voluntarily attended annual health screenings in the Third Xiangya Hospital of Central South University were included in the study. Logistic regression was used to determine the validity of hs-CRP to predict the presence of microalbuminuria. In the unadjusted regression analysis, male gender (OR 2.23), age (OR 1.71), smoking status (OR 1.48), obesity (OR 2.41), hypertension(OR 4.03), diabetes (OR 4.61), hyperuricemia (OR 1.83), and high hs-CRP(OR 1.61) were associated with microalbuminuria. Multivariate logistic regression analysis showed that the adjusted odds ratios (OR) of diabetes, hypertension, male, abdominal obesity, and high hs-CRP for microalbuminuria were 2.71, 2.57, 1.51, 1.28 and 1.41 in all subjects, respectively (P < 0.01). ROC analysis indicated that the cut-off for hs-CRP with better properties for screening of microalbuminuria was identified as ≥0.85 mg/L. The ORs of microalbuminuria were 1.97, 1.49, 1.32 and 1.71 times in male, abdominal obesity, diabetes and hypertension subjects with hs-CRP ≥ 0.85 mg/L, respectively, compared with those without elevated hs-CRP (P < 0.01). Elevated hs-CRP level was associated with microalbuminuria independent of cardiovascular risk factors. In addition, elevated hs-CRP increased the risk of developing microalbuminuria in subjects with CVD risk factors, indicating that chronic inflammation could amplify the deterioration of kidney by effect of CVD risk factors.
微量白蛋白尿是肾脏损伤的早期生物标志物，本研究旨在探讨高敏C反应蛋白（hs-CRP）对有心血管疾病（CVD）危险因素的成年人微量白蛋白尿的影响。共有5667名自愿参加中南大学湘雅三医院年度健康筛查的受试者纳入本研究。采用逻辑回归分析来确定hs-CRP预测微量白蛋白尿存在的有效性。在未校正的回归分析中，男性（比值比[OR] 2.23）、年龄（OR 1.71）、吸烟状况（OR 1.48）、肥胖（OR 2.41）、高血压（OR 4.03）、糖尿病（OR 4.61）、高尿酸血症（OR 1.83）和高hs-CRP（OR 1.61）与微量白蛋白尿相关。多因素逻辑回归分析显示，在所有受试者中，糖尿病、高血压、男性、腹型肥胖和高hs-CRP导致微量白蛋白尿的校正比值比分别为2.71、2.57、1.51、1.28和1.41（P<0.01）。受试者工作特征（ROC）分析表明，用于筛查微量白蛋白尿的具有更好性能的hs-CRP临界值被确定为≥0.85mg/L。与hs-CRP未升高的男性、腹型肥胖、糖尿病和高血压受试者相比，hs-CRP≥0.85mg/L的受试者微量白蛋白尿的比值比分别为1.97、1.49、1.32和1.71倍（P<0.01）。hs-CRP水平升高与微量白蛋白尿相关，且独立于心血管危险因素。此外，hs-CRP升高增加了有CVD危险因素的受试者发生微量白蛋白尿的风险，表明慢性炎症可通过CVD危险因素的作用加剧肾脏恶化。
