Gupta K K, Kotwal Mudit, Atam Virendra, Usman Kauser, Chaudhary S C, Kumar Ajay
Department of Medicine, King George's Medical University, Lucknow, Uttar Pradesh, India.
J Family Med Prim Care. 2020 Aug 25;9(8):3916-3920. doi: 10.4103/jfmpc.jfmpc_327_20. eCollection 2020 Aug.
Hypoxemia-induced endothelial dysfunction leads to microalbuminuria. Microalbuminuria (MAB) has also been used as a parameter to assess the risk of cardiovascular events in an individual. The aim of this study was to observe the relationship of MAB in patients with chronic obstructive pulmonary disease (COPD) and to correlate MAB with different stages of COPD.
This cross sectional study included 140 patients with COPD selected according to GOLD guidelines based on COPD test assessment score and the number of exacerbations who had smoking pack years of more than 10 years. Urine albumin creatinine ratio (UACR) more than 30 mg/gm represents MAB.
The UACR increases as the severity of groups of COPD increases with significant differences in UACR values among different COPD groups. Significant differences were seen among various groups of COPD when compared for different clinical parameters such as SPO2, PaO2, PaCO2, pH, and C-reactive protein (CRP). Pearson correlation analysis revealed that UACR was significantly inversely related with PaO2 ( = -0.514, < 0.001), SPO2 ( = -0.397, < 0.001) and FEV1 ( = -0.441, < 0.001) and it was significantly positively correlated with PaCO2 ( = 0.675, < 0.001).
This study indicates that there is strong relationship of MAB in patients with COPD and the levels of MAB increase as the severity of COPD increases due to hypoxia and endothelial dysfunction. As MAB is a marker for cardiovascular risk, patients with COPD can be routinely evaluated for the urine test of MAB specially who are at increased risk for cardiovascular events.
低氧血症诱导的内皮功能障碍导致微量白蛋白尿。微量白蛋白尿（MAB）也已被用作评估个体心血管事件风险的一个参数。本研究的目的是观察慢性阻塞性肺疾病（COPD）患者中MAB的关系，并将MAB与COPD的不同阶段相关联。
这项横断面研究纳入了140例根据GOLD指南基于COPD测试评估分数和加重次数选择的COPD患者，这些患者的吸烟包年数超过10年。尿白蛋白肌酐比值（UACR）大于30mg/gm表示存在MAB。
随着COPD组严重程度增加，UACR升高，不同COPD组之间的UACR值存在显著差异。在比较不同临床参数如SPO2、PaO2、PaCO2、pH和C反应蛋白（CRP）时，不同COPD组之间存在显著差异。Pearson相关性分析显示，UACR与PaO2（r = -0.514，P < 0.001）、SPO2（r = -0.397，P < 0.001）和FEV1（r = -0.441，P < 0.001）显著负相关，与PaCO2（r = 0.675，P < 0.001）显著正相关。
本研究表明，COPD患者中MAB存在密切关系，并且由于缺氧和内皮功能障碍，随着COPD严重程度增加，MAB水平升高。由于MAB是心血管风险的标志物，COPD患者可常规进行MAB尿检评估，特别是那些心血管事件风险增加的患者。
