Leiden University Medical Center, Dept. of Radiology, Leiden, The Netherlands.
Leiden University Medical Center, Dept. of Clinical Epidemiology, Leiden, The Netherlands.
Atherosclerosis. 2018 May;272:94-100. doi: 10.1016/j.atherosclerosis.2018.03.029. Epub 2018 Mar 16.
In patients with impaired renal function and macroalbuminuria, cardiovascular risk factors are highly prevalent, however, whether this is also present in the general population is unclear. We investigated whether normal-range albuminuria and renal function are associated with cardiovascular function in the general population.
In this cross-sectional analysis of the NEO study, urinary albumin-creatinine ratio (UACR), estimated glomerular filtration rate (eGFR), and intima-media thickness were assessed in all participants (n = 6503), and a random subset underwent MRI for pulse wave velocity (n = 2451) and/or cardiac imaging (n = 1138).
Multiple linear regression analysis was performed while adjusting for sex, age, smoking, mean arterial blood pressure, total body fat, and fasting glucose. After adjustment, albuminuria and renal function were positively associated with left ventricle (LV) mass index (UACR, 0.941 g/m [95% CI: 0.21,1.67] p = 0.012; eGFR, 0.748 g/m [95% CI: 0.15,1.35] p = 0.015) and LV cardiac index (UACR, 0.056 L/min/m [95% CI: 0.00,0.11] p = 0.038; eGFR, 0.080 L/min/m [95% CI: 0.03,0.13] p = 0.001). Albuminuria showed a weak association with arterial thickness (UACR, 0.003 mm [95% CI: 0.00,0.01] p = 0.015) and arterial stiffness (UACR, 0.073 m/s [95% CI: 0.01,0.13] p = 0.036), but not with renal function. No associations were observed for LV ejection fraction and LV diastolic function.
Normal-range albuminuria was positively associated with LV mass index, LV cardiac index, arterial thickness and arterial stiffness. Our findings support the hypothesis that even within normal range, albuminuria is a marker of cardiovascular health.
在肾功能受损和大量蛋白尿的患者中，心血管危险因素高度流行，然而，普通人群中是否也存在这种情况尚不清楚。我们研究了正常范围内的白蛋白尿和肾功能是否与普通人群的心血管功能有关。
在 NEO 研究的这项横断面分析中，评估了所有参与者的尿白蛋白/肌酐比值（UACR）、估算肾小球滤过率（eGFR）和内膜中层厚度（n=6503），并随机选择一部分参与者进行磁共振成像（MRI）进行脉搏波速度（n=2451）和/或心脏成像（n=1138）。
进行了多元线性回归分析，同时调整了性别、年龄、吸烟、平均动脉血压、全身脂肪和空腹血糖。调整后，白蛋白尿和肾功能与左心室（LV）质量指数呈正相关（UACR，0.941 g/m[95%CI：0.21，1.67]，p=0.012；eGFR，0.748 g/m[95%CI：0.15，1.35]，p=0.015）和 LV 心输出量指数（UACR，0.056 L/min/m[95%CI：0.00，0.11]，p=0.038；eGFR，0.080 L/min/m[95%CI：0.03，0.13]，p=0.001）。白蛋白尿与动脉厚度（UACR，0.003 mm[95%CI：0.00，0.01]，p=0.015）和动脉僵硬（UACR，0.073 m/s[95%CI：0.01，0.13]，p=0.036）呈弱相关，但与肾功能无关。LV 射血分数和 LV 舒张功能无相关性。
正常范围内的白蛋白尿与 LV 质量指数、LV 心输出量指数、动脉厚度和动脉僵硬呈正相关。我们的研究结果支持这样一种假设，即即使在正常范围内，白蛋白尿也是心血管健康的标志物。
