Cho Myung Hyun, Kim Kyo Sun, Chung Sochung
Department of Pediatrics, Konkuk University Medical Center.
Department of Pediatrics, Konkuk University School of Medicine.
Tohoku J Exp Med. 2017 Nov;243(3):151-157. doi: 10.1620/tjem.243.151.
Microalbuminuria (MA) is a well-known predictor of cardiovascular disease and mortality in adults. However, these relationships remain unclear in adolescents. A few studies on association between MA and obesity have been conducted in adolescents. However, the association between MA and growth parameters such as height has not been studied, despite the fact that adolescence is a period of rapid physiological change. We, therefore, aimed to evaluate the association between MA and growth parameters, and the association between MA and obesity related cardiovascular risk factors after adjusting for growth. The study included 1,459 adolescents (847 boys and 612 girls) aged 12-18 years who participated in the Korean National Health and Nutrition Examination Survey (2011-2013). A urine albumin/creatinine ratio (UACR) of 30-299 mg/g in a morning urine sample was considered to reflect MA. MA was detected in 53 (3.6%) including 24 girls. Height z-score of adolescents with MA was greater than that of normoalbuminuric adolescents (0.87 vs. 0.38; P < 0.01). Upon multiple regression analysis, UACR was associated with lower weight z-score (β = -0.100, P < 0.01) and higher height z-score (β = 0.069, P < 0.01). In term of cardiovascular risk factors, the UACR was not associated with fasting glucose, high-density-lipoprotein cholesterol, or triglyceride levels. Adolescents with MA tend to be thin and tall. MA is not a useful screening method for obesity-related cardiovascular risk in adolescents, but instead MA is associated with taller height and lower weight, growth-related parameters in adolescence.
微量白蛋白尿(MA)是成人心血管疾病和死亡率的一个众所周知的预测指标。然而,这些关系在青少年中仍不明确。关于青少年MA与肥胖之间关联的研究已有一些。然而,尽管青春期是生理快速变化的时期,但MA与身高之类的生长参数之间的关联尚未得到研究。因此,我们旨在评估MA与生长参数之间的关联,以及在调整生长因素后MA与肥胖相关心血管危险因素之间的关联。该研究纳入了1459名12至18岁的青少年(847名男孩和612名女孩),他们参加了韩国国家健康与营养检查调查(2011 - 2013年)。晨尿样本中尿白蛋白/肌酐比值(UACR)为30 - 299mg/g被认为反映MA。在53名(3.6%)青少年中检测到MA,其中包括24名女孩。MA青少年的身高Z评分高于正常白蛋白尿青少年(0.87对0.38;P < 0.01)。经过多元回归分析,UACR与较低的体重Z评分(β = -0.100,P < 0.01)和较高的身高Z评分(β = 0.069,P < 0.01)相关。就心血管危险因素而言,UACR与空腹血糖、高密度脂蛋白胆固醇或甘油三酯水平无关。MA青少年往往偏瘦且高。MA并非青少年肥胖相关心血管风险的有效筛查方法,相反,MA与更高的身高和更低的体重相关,这些是青春期与生长相关的参数。