Department of Endocrinology, The First Medical Center of PLA General Hospital, Beijing, China.
Department of Endocrinology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Front Endocrinol (Lausanne). 2022 May 20;13:864562. doi: 10.3389/fendo.2022.864562. eCollection 2022.
Albuminuria has been widely considered a risk factor for cardiovascular diseases (CVDs), which is associated with hypertension (HTN), type 2 diabetes mellitus (T2DM), HTN with T2DM, and dyslipidemia. However, the associations between albuminuria and HTN, T2DM, HTN with T2DM, dyslipidemia, and CVDs are still unclear. Thus, this study aimed to explore the association of albuminuria thoroughly, especially within the normal range, with the abovementioned diseases in the Chinese population.
This study included 40,188 participants aged over 40 years from seven centers across China. Urinary albumin-creatinine ratio (UACR) was firstly divided into the ≥30-mg/g group, indicating kidney damage, and <30-mg/g group. Furthermore, UACR was divided into five groups: the <20%, 20%-39%, 40%-59%, 60%-79%, and ≥80% groups, according to the quintile division of participants within the normal range. Propensity score matching was used to reduce bias, and multiple logistic regression models were conducted to examine the association between UACR and HTN, T2DM, HTN with T2DM, dyslipidemia, and CVDs.
Multivariable regression analysis revealed that UACR, even within the normal range, is significantly associated with HTN, T2DM, HTN with T2DM, dyslipidemia, and CVDs, and the association between UACR and HTN with T2DM was the most significant in model 3 even after adjusting for confounding factors (HTN: OR = 1.56 (95% CI = 1.45-1.68), < 0.0001; T2DM: OR = 1.78 (95% CI = 1.60-1.97), < 0.0001; HTN with T2DM: OR = 1.76 (95% CI = 1.59-1.95), < 0.0001; dyslipidemia: OR = 1.08 (95% CI = 1.01-1.14), = 0.0146; CVDs: OR = 1.12 (95% CI = 1.00-1.25), = 0.0475). In the stratified analysis, high normal UACR was significantly associated with HTN, T2DM, HTN with T2DM, and dyslipidemia in subgroups.
In summary, we observe a higher prevalence of HTN, T2DM, HTN with T2DM, dyslipidemia, and CVDs in abnormal UACR and reveal a significant association of UACR, even within the normal range, with HTN, T2DM, HTN with T2DM, dyslipidemia, and CVDs.
白蛋白尿已被广泛认为是心血管疾病 (CVDs) 的危险因素，与高血压 (HTN)、2 型糖尿病 (T2DM)、HTN 合并 T2DM 和血脂异常有关。然而，白蛋白尿与 HTN、T2DM、HTN 合并 T2DM、血脂异常和 CVDs 之间的关联仍不清楚。因此，本研究旨在深入探讨白蛋白尿与上述疾病之间的关系，尤其是在正常范围内的白蛋白尿与上述疾病之间的关系。
本研究纳入了来自中国七个中心的 40188 名年龄超过 40 岁的参与者。尿白蛋白肌酐比值 (UACR) 首先分为≥30mg/g 组，表明肾脏损伤，和 <30mg/g 组。此外，根据正常范围内参与者的五分位分组，将 UACR 分为<20%、20%-39%、40%-59%、60%-79%和≥80%组。采用倾向性评分匹配减少偏倚，采用多变量逻辑回归模型分析 UACR 与 HTN、T2DM、HTN 合并 T2DM、血脂异常和 CVDs 之间的关系。
多变量回归分析显示，即使在正常范围内，UACR 也与 HTN、T2DM、HTN 合并 T2DM、血脂异常和 CVDs 显著相关，并且 UACR 与 HTN 合并 T2DM 之间的关联在模型 3 中最为显著，即使在调整了混杂因素后（HTN：OR=1.56（95%CI=1.45-1.68），<0.0001；T2DM：OR=1.78（95%CI=1.60-1.97），<0.0001；HTN 合并 T2DM：OR=1.76（95%CI=1.59-1.95），<0.0001；血脂异常：OR=1.08（95%CI=1.01-1.14），=0.0146；CVDs：OR=1.12（95%CI=1.00-1.25），=0.0475）。在分层分析中，高正常 UACR 与 HTN、T2DM、HTN 合并 T2DM 和血脂异常亚组显著相关。
综上所述，我们观察到异常 UACR 组中 HTN、T2DM、HTN 合并 T2DM、血脂异常和 CVDs 的患病率更高，并揭示了 UACR，即使在正常范围内，与 HTN、T2DM、HTN 合并 T2DM、血脂异常和 CVDs 之间存在显著关联。
