State Key Laboratory of Organ Failure Research, Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
Biomed Res Int. 2020 Jan 21;2020:5240153. doi: 10.1155/2020/5240153. eCollection 2020.
Several studies show that even a level of urine albumin/creatinine ratio (UACR) within the normal range (below 30 mg/g) increases the risk of cardiovascular diseases. We speculate that mildly increased UACR is related to left ventricular hypertrophy (LVH) in patients with type 2 diabetes mellitus (T2DM). In this retrospective study, 317 patients with diabetes with normal UACR, of whom 62 had LVH, were included. The associations between UACR and laboratory indicators, as well as LVH, were examined using multivariate linear regression and logistic regression, respectively. The diagnostic efficiency and the optimal cutoff point of UACR for LVH were evaluated using the area under the receiver operating characteristic curve (AUC) and Youden index. Our results showed that patients with LVH had significantly higher UACR than those without LVH ( < 0.001). The prevalence of LVH presented an upward trend with the elevation of UACR. UACR was independently and positively associated with hemoglobin A1c ( < 0.001). UACR can differentiate LVH (AUC = 0.682, 95% CI (0.602-0.760), < 0.001). The optimal cutoff point determined with the Youden index was UACR = 10.2 mg/g. When categorized by this cutoff point, the odds ratio (OR) for LVH in patients in the higher UACR group (10.2-30 mg/g) was 3.104 (95% CI: 1.557-6.188, =0.001) compared with patients in the lower UACR group (<10.2 mg/g). When UACR was analyzed as a continuous variable, every double of increased UACR, the OR for LVH was 1.511 (95% CI: 1.047-2.180, =0.028). Overall, UACR below 30 mg/g is associated with LVH in patients with T2DM. The optimal cutoff value of UACR for identifying LVH in diabetes is 10 mg/g.
几项研究表明，即使在正常范围内（低于 30mg/g）的尿白蛋白/肌酐比值（UACR）水平升高也会增加心血管疾病的风险。我们推测，2 型糖尿病（T2DM）患者中轻度升高的 UACR 与左心室肥厚（LVH）有关。在这项回顾性研究中，纳入了 317 例 UACR 正常的糖尿病患者，其中 62 例患有 LVH。使用多元线性回归和逻辑回归分别检查 UACR 与实验室指标以及与 LVH 的关系。使用受试者工作特征曲线（AUC）下的面积和 Youden 指数评估 UACR 对 LVH 的诊断效率和最佳截断点。我们的结果表明，患有 LVH 的患者的 UACR 明显高于没有 LVH 的患者（<0.001）。LVH 的患病率随着 UACR 的升高呈上升趋势。UACR 与糖化血红蛋白 A1c 呈独立正相关（<0.001）。UACR 可以区分 LVH（AUC=0.682，95%CI（0.602-0.760），<0.001）。Youden 指数确定的最佳截断点为 UACR=10.2mg/g。当根据该截断点进行分类时，UACR 较高组（10.2-30mg/g）患者发生 LVH 的比值比（OR）为 3.104（95%CI：1.557-6.188，=0.001），与 UACR 较低组（<10.2mg/g）患者相比。当 UACR 作为连续变量进行分析时，UACR 每增加一倍，LVH 的 OR 为 1.511（95%CI：1.047-2.180，=0.028）。总的来说，T2DM 患者的 UACR 低于 30mg/g 与 LVH 有关。UACR 用于识别糖尿病中 LVH 的最佳截断值为 10mg/g。
