First Affiliated Hospital of Hainan Medical University, Haikou, China.
Marketing Department, Sanofi (Hangzhou), Haikou, China.
BMC Nephrol. 2021 Nov 5;22(1):366. doi: 10.1186/s12882-021-02576-8.
Urine albumin/creatinine ratio (UACR) is an important marker of early renal damage (ERD) caused by hypertension. Recent studies showed that blood pressure was a significant inverse association with temperature and climate. The purposes of our study were sought to explore the association of common medical comorbidities with ERD, and find independent risk factors to ERD in Chinese tropics with essential hypertension.
From January 2018 to December 2019, we assessed UACR in a total of 599 hypertensive Chinese Hainan patients. We defined ERD as a UACR between 30 mg/g and 300 mg/g. We analysed differences between qualitative variables using the chi-squared (χ) test. We calculated correlations between UACR and age, hypertension duration (HD), systolic blood pressure (SBP), and diastolic blood pressure (DBP) using the Spearman's rho test. To determine the odds ratio (OR), we evaluated binary logistic regression models.
Among the 599 patients, 281 (46.9%) were found to have ERD. ERD and factors related to sex, body mass index (BMI), and SBP did not differ significantly (all, p>0.05). Our main findings showed that age, HD, and DBP were associated with ERD (p<0.01, respectively). Furthermore, age ≥ 65 years, HD ≥10 years, DBP ≥ 90 mmHg, SBP ≥ 160 mmHg, and diabetes differed significantly according to ERD status (p < 0.05, respectively). In multivariate analysis using stepwise regression, age (OR = 1.468), DBP (OR = 1.853), and diabetes (OR = 2.031) were significant independent predictors of ERD. The area under the receiver operating characteristic (ROC) curve was 0.677, and the sensitivity and specificity of the optimal cut-off value were 44.5 and 81.1%, respectively.
Common medical comorbidities are associated with ERD; age, DBP, and diabetes are independent risk factors for ERD in patients with essential hypertension who live in the Chinese tropics. Early monitoring of the UACR, as well as control of blood glucose and DBP, can effectively delay ERD.
尿白蛋白/肌酐比值（UACR）是高血压引起的早期肾损伤（ERD）的重要标志物。最近的研究表明，血压与温度和气候呈显著负相关。本研究旨在探讨中国热带地区高血压合并常见合并症与 ERD 的关系，并寻找 ERD 的独立危险因素。
本研究于 2018 年 1 月至 2019 年 12 月期间评估了 599 例海南高血压患者的 UACR。我们将 ERD 定义为 UACR 在 30mg/g 至 300mg/g 之间。我们使用卡方（χ）检验分析定性变量之间的差异。我们使用斯皮尔曼 rho 检验计算 UACR 与年龄、高血压病程（HD）、收缩压（SBP）和舒张压（DBP）之间的相关性。为了确定比值比（OR），我们评估了二元逻辑回归模型。
在 599 例患者中，281 例（46.9%）被发现存在 ERD。ERD 与性别、体重指数（BMI）和 SBP 相关的因素无显著差异（均，p>0.05）。我们的主要发现表明，年龄、HD 和 DBP 与 ERD 相关（均，p<0.01）。此外，年龄≥65 岁、HD≥10 年、DBP≥90mmHg、SBP≥160mmHg 和糖尿病根据 ERD 状态差异显著（均，p<0.05）。使用逐步回归的多变量分析，年龄（OR=1.468）、DBP（OR=1.853）和糖尿病（OR=2.031）是 ERD 的显著独立预测因子。接收者操作特征（ROC）曲线下面积为 0.677，最佳截断值的敏感性和特异性分别为 44.5%和 81.1%。
常见合并症与 ERD 相关；年龄、DBP 和糖尿病是中国热带地区高血压患者 ERD 的独立危险因素。早期监测 UACR 以及控制血糖和 DBP 可以有效延缓 ERD 的发生。
