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韩国青少年微量白蛋白尿的患病率及其相关的心脏代谢危险因素:来自韩国国家健康与营养检查调查的数据。

Prevalence of microalbuminuria and its associated cardiometabolic risk factors in Korean youth: Data from the Korea National Health and Nutrition Examination Survey.

作者信息

Cho Heeyeon, Kim Jae Hyun

机构信息

Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.

出版信息

PLoS One. 2017 Jun 2;12(6):e0178716. doi: 10.1371/journal.pone.0178716. eCollection 2017.

Abstract

BACKGROUND

Microalbuminuria is a known early predictive factor for renal and cardiovascular diseases, not only for patients with diabetes mellitus or hypertension but also in the general population. However, the prevalence and risk factors associated with microalbuminuria in Korean youth are unknown.

OBJECTIVES

The aims of this study are to evaluate the prevalence of microalbuminuria and the association between microalbuminuria and obesity or cardiometabolic risk factors in Korean children and adolescents without diabetes.

METHODS

This study examines data obtained from the Korea National Health and Nutrition Examination Survey (between 2011 and 2014). It includes a total of 1,976 participants aged between 10 and 19 years (boys 1,128 and girls 848). Microalbuminuria was defined as a urine albumin-to-creatinine ratio (UACR) of ≥ 30 mg/g and < 300 mg/g. Association between microalbuminuria and the risk factors for cardiometabolic diseases including insulin resistance was evaluated.

RESULTS

The prevalence of microalbuminuria was found to be 3.0% in Korean children and adolescents over this time period. The mean UACR for non-obese youth was significantly greater than that found in obese youth (3.2 ± 0.1 mg/g in the non-obese group vs. 2.1 ± 0.2 mg/g in the obese group; P < 0.001). In multiple logistic regression analysis, microalbuminuria was associated with hyperglycemia (OR 2.62, 95% CI 1.09-6.30) and hemoglobin A1c (OR 3.34, 95% CI 1.09-10.17) in the non-obese group and hypertension (OR 14.10, 95% CI 1.12-177.98) and HbA1c (OR 6.68, 95% CI 1.87-23.95) in the obese group.

CONCLUSIONS

The prevalence of microalbuminuria is not prominent in obese children and adolescents. Our findings demonstrated that the presence of hypertension and hyperglycemia was associated with microalbuminuria. Especially Hemoglobin A1c was associated with microalbuminuria in youths regardless of weight status. Microalbuminuria in pediatric population can be a helpful marker for the risk of cardiovascular disease.

摘要

背景

微量白蛋白尿是肾脏疾病和心血管疾病已知的早期预测因素,不仅适用于糖尿病或高血压患者,在普通人群中也是如此。然而,韩国青少年中微量白蛋白尿的患病率及相关危险因素尚不清楚。

目的

本研究旨在评估韩国无糖尿病儿童及青少年中微量白蛋白尿的患病率,以及微量白蛋白尿与肥胖或心脏代谢危险因素之间的关联。

方法

本研究分析了韩国国家健康与营养检查调查(2011年至2014年)的数据。研究共纳入1976名年龄在10至19岁之间的参与者(男孩1128名,女孩848名)。微量白蛋白尿定义为尿白蛋白肌酐比值(UACR)≥30mg/g且<300mg/g。评估了微量白蛋白尿与包括胰岛素抵抗在内的心脏代谢疾病危险因素之间的关联。

结果

在此期间,韩国儿童及青少年中微量白蛋白尿的患病率为3.0%。非肥胖青少年的平均UACR显著高于肥胖青少年(非肥胖组为3.2±0.1mg/g,肥胖组为2.1±0.2mg/g;P<0.001)。在多因素logistic回归分析中,非肥胖组中微量白蛋白尿与高血糖(比值比2.62,95%置信区间1.09 - 6.30)和糖化血红蛋白(比值比3.34,95%置信区间1.09 - 10.17)相关,肥胖组中微量白蛋白尿与高血压(比值比14.10,95%置信区间1.12 - 177.98)和糖化血红蛋白(比值比6.68,95%置信区间1.87 - 23.95)相关。

结论

肥胖儿童及青少年中微量白蛋白尿的患病率并不突出。我们的研究结果表明,高血压和高血糖与微量白蛋白尿有关。尤其是糖化血红蛋白,无论体重状况如何,均与青少年微量白蛋白尿有关。儿童人群中的微量白蛋白尿可能是心血管疾病风险的一个有用指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/069f/5456094/842e5ef62372/pone.0178716.g001.jpg

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