Department of Nephrology, Hiroshima University Hospital, Hiroshima, Japan.
Center for Integrated Medical Research, Hiroshima University Hospital, Hiroshima, Japan.
PLoS One. 2019 Aug 1;14(8):e0218290. doi: 10.1371/journal.pone.0218290. eCollection 2019.
Low-grade albuminuria has been considered a predictor of cardiovascular mortality. We investigated the relationship between high-normal albuminuria and subclinical atherosclerosis in non-diabetic men with estimated glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m2.
In this cross-sectional study, 1,756 men with eGFR ≥60 mL/min/1.73 m2 and urine albumin-to-creatinine ratio (UACR) <30 mg/g, who attended general health checkups between April 2012 and March 2015, underwent blood sampling, urinalysis, and carotid ultrasonography. We excluded the subjects who were diabetic and/or received an anti-hypertensive drug. Carotid intima-media thickness (IMT) and the number of focal atheromatous plaques were used as indicators of subclinical atherosclerosis. Multiple linear regression analysis was performed to identify clinical factors associated with carotid IMT. Poisson regression analysis was used to assess the determinants of the carotid plaque number.
Median UACR was 4.8 mg/g (interquartile range, 3.6-6.9 mg/g). Compared with subjects with low-normal UACR (<10.0 mg/g), subjects with high-normal UACR (10.0-29.8 mg/g) had greater IMT and higher carotid plaque number. High-normal UACR was independently associated with thickened IMT in the model adjusted for conventional cardiovascular disease risk factors. Moreover, participants with high-normal UACR were also more likely to be associated with increased plaque count (prevalence ratio: 1.06; 95% confidence interval: 1.01-1.14) after adjustment for conventional cardiovascular disease risk factors.
Our results indicate that high-normal albuminuria is associated with both carotid IMT and plaque formation in the non-diabetic male population with eGFR ≥60 mL/min/1.73 m2.
低水平白蛋白尿已被认为是心血管死亡率的预测指标。我们研究了肾小球滤过率(eGFR)≥60 mL/min/1.73 m2的非糖尿病男性中高正常白蛋白尿与亚临床动脉粥样硬化之间的关系。
在这项横断面研究中,共有 1756 名 eGFR≥60 mL/min/1.73 m2 且尿白蛋白与肌酐比值(UACR)<30 mg/g 的男性参加了 2012 年 4 月至 2015 年 3 月期间的常规健康检查,他们接受了血液采样、尿液分析和颈动脉超声检查。我们排除了患有糖尿病和/或服用抗高血压药物的患者。颈动脉内膜中层厚度(IMT)和局灶性粥样硬化斑块数量被用作亚临床动脉粥样硬化的指标。使用多元线性回归分析来确定与颈动脉 IMT 相关的临床因素。使用泊松回归分析评估颈动脉斑块数量的决定因素。
UACR 的中位数为 4.8 mg/g(四分位间距,3.6-6.9 mg/g)。与 UACR 低正常者(<10.0 mg/g)相比,UACR 高正常者(10.0-29.8 mg/g)的 IMT 更大,颈动脉斑块数量更多。在调整了常规心血管疾病危险因素的模型中,高正常 UACR 与 IMT 增厚独立相关。此外,在调整了常规心血管疾病危险因素后,高正常 UACR 者颈动脉斑块数量增加的可能性也更高(患病率比:1.06;95%置信区间:1.01-1.14)。
我们的研究结果表明,在 eGFR≥60 mL/min/1.73 m2 的非糖尿病男性人群中,高正常白蛋白尿与颈动脉 IMT 和斑块形成均相关。