Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei, Taiwan.
School of Life Science, National Taiwan Normal University, Taipei, Taiwan.
Dis Markers. 2022 Jul 25;2022:3549047. doi: 10.1155/2022/3549047. eCollection 2022.
A spot urine creatinine-to-osmolality ratio (sUCr/Osm) is proposed as a surrogate of the urinary excretion rate of creatinine (Cr) and convenient for forecasting serum Cr (SCr) trends. The lower the sUCr/Osm, the lower the excreted Cr amount accompanied by per unit of osmoles, the higher the risk of Cr accumulation. For exploring the reference intervals of sUCr/Osm in general adults, a cross-sectional analysis was performed on a subset of data from the National Health and Nutrition Examination Survey (NHANES) 2011-2012. Of the eligible 3,316 adults aged 18.0 to 79.9 years, the age (mean ± SD) was 45.2 ± 17.2 years old, women was 45.02%, body weight (BW) was 76.1 ± 14.5 kg, and African Americans was 23.6%. Blood urea nitrogen (BUN) was 12.6 ± 4.7 mg/dL; SCr was 0.89 ± 0.34 mg/dL. As spot urine Cr and osmolality were 127.1 ± 84.0 mg/dl and 649 ± 266 mOsm/kg, respectively, sUCr/Osm was 0.19 ± 0.08. With adjustment of factors related to personal urinary excretion of Cr and osmoles by multivariable regression analysis, the estimated sUCr/Osm (esUCr/Osm) for an individual was 0.153 × (age in year) × (BW in kg) × 1.244 [if African American] × (BUN in mg/dL) × (SCr in mg/dL). The index of sUCr/Osm to personalized esUCr/Osm was 1.05 ± 0.39. When only low urinary excretion of Cr is likely to be of clinical concern, further analysis showed 157 individuals (4.7%, outside the 5th percentile) had their original sUCr/Osm < 0.08; 157 had the sUCr/Osm indexed for personalized esUCr/Osm < 0.50.
建议使用尿肌酐-渗透压比值（sUCr/Osm）作为肌酐（Cr）排泄率的替代指标，并且方便预测血清 Cr（SCr）的趋势。sUCr/Osm 值越低，单位渗透压排泄的 Cr 量越低，Cr 蓄积的风险越高。为了探讨一般成年人 sUCr/Osm 的参考区间，对 2011-2012 年国家健康和营养调查（NHANES）的部分数据进行了横断面分析。在符合条件的 3316 名年龄在 18.0 至 79.9 岁的成年人中，年龄（均值±标准差）为 45.2±17.2 岁，女性占 45.02%，体重（BW）为 76.1±14.5kg，非裔美国人占 23.6%。血尿素氮（BUN）为 12.6±4.7mg/dL；SCr 为 0.89±0.34mg/dL。由于尿 Cr 和渗透压分别为 127.1±84.0mg/dl 和 649±266mOsm/kg，sUCr/Osm 为 0.19±0.08。通过多元回归分析调整与个人 Cr 和渗透压尿排泄相关的因素后，个体的估计 sUCr/Osm（esUCr/Osm）为 0.153×（年龄以年计）×（BW 以 kg 计）×1.244[如果是非洲裔美国人]×（BUN 以 mg/dL 计）×（SCr 以 mg/dL 计）。sUCr/Osm 与个性化 esUCr/Osm 的指数为 1.05±0.39。当仅低尿 Cr 排泄可能引起临床关注时，进一步分析显示 157 名个体（4.7%，低于第 5 百分位数）的原始 sUCr/Osm<0.08；157 名个体的 sUCr/Osm 经个性化 esUCr/Osm 校正后<0.50。
