Department of Pediatrics, Beatrix Children's Hospital, University of Groningen, University Medical Center Groningen, P.O. Box 30.001-CA13, Groningen, 9700RB, The Netherlands.
Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Pediatr Nephrol. 2023 Aug;38(8):2897-2900. doi: 10.1007/s00467-022-05850-5. Epub 2023 Jan 27.
Mildly increased albuminuria is common in the general adult population and is a strong predictor for cardiovascular events, even in otherwise healthy individuals. The underlying pathophysiological process could be endothelial dysfunction. Previously, we reported that increased albuminuria can also be found in 2-year-olds from the general population. We hypothesized that some individuals have constitutionally higher levels of albuminuria, possibly as an expression of early or inborn endothelial dysfunction. The aim of this study is to evaluate longitudinal persistence of albuminuria from infancy into school age.
In the population-based GECKO (Groningen Expert Center for Kids with Obesity) cohort, urine was collected from 816 children at the age of 2 years as well as 12 years (random urine and first morning void urine, respectively). We evaluated prevalence and persistence of increased albuminuria (U ≥ 3 mg/mmol) at the two time points.
The prevalence of U ≥ 3 mg/mmol at 2 and 12 years of age was 31.9% (95% CI 28.7-35.2) and 3.1% (95% CI 2.0-4.5), respectively. U < 3 mg/mmol at both 2 and 12 years of age was present in 540 children (66.2%). Only 9 children (3.5%) of the 260 children with an U ≥ 3 mg/mmol at 2 years had an U ≥ 3 mg/mmol at 12 years (p < 0.001).
Albuminuria in 2-year-olds does largely not persist until the age of 12, indicating that albuminuria at 2 years of age is not a marker for constitutional endothelial dysfunction in this cohort. A higher resolution version of the Graphical abstract is available as Supplementary information.
微量白蛋白尿在普通成年人群中很常见，是心血管事件的强有力预测指标，即使在其他方面健康的个体中也是如此。潜在的病理生理过程可能是内皮功能障碍。此前，我们报道在普通人群中的 2 岁儿童中也存在白蛋白尿增加的情况。我们假设，一些个体的白蛋白尿水平本来就较高，这可能是内皮功能早期或先天障碍的表现。本研究旨在评估从婴儿期到学龄期白蛋白尿的纵向持续性。
在基于人群的 GECKO（格罗宁根儿童肥胖专家中心）队列中，816 名儿童在 2 岁和 12 岁时采集尿液（分别为随机尿和晨尿）。我们评估了这两个时间点白蛋白尿增加（U≥3mg/mmol）的患病率和持续性。
2 岁和 12 岁时 U≥3mg/mmol 的患病率分别为 31.9%（95%CI 28.7-35.2）和 3.1%（95%CI 2.0-4.5）。在 2 岁和 12 岁时 U<3mg/mmol 的儿童有 540 名（66.2%）。在 2 岁时 U≥3mg/mmol 的 260 名儿童中，仅有 9 名（3.5%）在 12 岁时 U≥3mg/mmol（p<0.001）。
2 岁时的白蛋白尿在很大程度上不会持续到 12 岁，这表明该队列中 2 岁时的白蛋白尿不是固有内皮功能障碍的标志物。更清晰的图表版本可以作为补充信息获取。
