Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States of America.
Department of Radiological Sciences, University of California Irvine School of Medicine, Irvine, CA, United States of America.
PLoS One. 2019 Jan 17;14(1):e0210973. doi: 10.1371/journal.pone.0210973. eCollection 2019.
Breast arterial calcification (BAC) may be a predictor of cardiovascular events and is highly prevalent in persons with end-stage kidney disease. However, few studies to date have examined the association between mild-to-moderate kidney function and proteinuria with BAC.
We prospectively enrolled women with no prior cardiovascular disease aged 60 to 79 years undergoing mammography screening at Kaiser Permanente Northern California between 10/24/2012 and 2/13/2015. Urine albumin-to-creatinine ratio (uACR), along with specific laboratory, demographic, and medical data, were measured at the baseline visit. Baseline estimated glomerular filtration rate (eGFR), medication history, and other comorbidities were identified from self-report and/or electronic medical records. BAC presence and gradation (mass) was measured by digital quantification of full-field mammograms.
Among 3,507 participants, 24.5% were aged ≥70 years, 63.5% were white, 7.5% had eGFR <60 ml/min/1.73m2, with 85.7% having uACR ≥30 mg/g and 3.3% having uACR ≥300 mg/g. The prevalence of any measured BAC (>0 mg) was 27.9%. Neither uACR ≥30 mg/g nor uACR ≥300 were significantly associated with BAC in crude or multivariable analyses. Reduced eGFR was associated with BAC in univariate analyses (odds ratio 1.53, 95% CI: 1.18-2.00), but the association was no longer significant after adjustment for potential confounders. Results were similar in various sensitivity analyses that used different BAC thresholds or analytic approaches.
Among women without cardiovascular disease undergoing mammography screening, reduced eGFR and albuminuria were not significantly associated with BAC.
乳腺动脉钙化（BAC）可能是心血管事件的预测因子，在终末期肾病患者中发病率很高。然而，迄今为止，很少有研究探讨轻度至中度肾功能不全和蛋白尿与 BAC 之间的关系。
我们前瞻性地招募了年龄在 60 至 79 岁之间、无既往心血管疾病且在 2012 年 10 月 24 日至 2015 年 2 月 13 日期间在 Kaiser Permanente 北加利福尼亚州进行乳房 X 光筛查的女性。基线检查时测量了尿白蛋白与肌酐比值（uACR）以及特定的实验室、人口统计学和医疗数据。从自我报告和/或电子病历中确定了基线时的估计肾小球滤过率（eGFR）、用药史和其他合并症。通过对全视野乳房 X 光片的数字量化来测量 BAC 的存在和分级（质量）。
在 3507 名参与者中，24.5%的人年龄≥70 岁，63.5%的人是白人，7.5%的人 eGFR<60ml/min/1.73m2，85.7%的人 uACR≥30mg/g，3.3%的人 uACR≥300mg/g。任何有测量的 BAC（>0mg）的患病率为 27.9%。在未经调整和多变量分析中，uACR≥30mg/g 或 uACR≥300mg/g 均与 BAC 无显著相关性。在单变量分析中，降低的 eGFR 与 BAC 相关（比值比 1.53，95%置信区间：1.18-2.00），但在调整潜在混杂因素后，这种相关性不再显著。在使用不同的 BAC 阈值或分析方法的各种敏感性分析中，结果相似。
在接受乳房 X 光筛查的无心血管疾病的女性中，降低的 eGFR 和白蛋白尿与 BAC 无显著相关性。
