Department of Cardiology, First Affiliated Hospital of Medical School, Xi'an Jiaotong University, No. 277, Yanta West Road, Xi'an, 710061, China.
Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China.
BMC Public Health. 2023 Apr 11;23(1):666. doi: 10.1186/s12889-023-15613-y.
Albuminuria is recognized as being a predictor of cardiovascular and renal disease. We aimed to identify the impact of the long-term burden and trends of systolic blood pressure on albuminuria in midlife, as well as to explore sex differences concerning this relationship.
This longitudinal study consisted of 1,683 adults who had been examined 4 or more times for blood pressure starting in childhood, with a follow-up time period of 30 years. The cumulative effect and longitudinal trend of blood pressure were identified by using the area under the curve (AUC) of individual systolic blood pressure measurement with a growth curve random effects model.
Over 30 years of follow-up, 190 people developed albuminuria, including 53.2% males and 46.8% females (aged 43.39 ± 3.13 years in the latest follow-up). The urine albumin-to-creatinine ratio (uACR) values increased as the total and incremental AUC values increased. Additionally, women had a higher albuminuria incidence in the higher SBP AUC groups than men do (13.3% for men vs. 33.7% for women). Logistic regression showed that the ORs of albuminuria for males and females in the high total AUC group were 1.34 (0.70-2.60) and 2.94 (1.50-5.74), respectively. Similar associations were found in the incremental AUC groups.
Higher cumulative SBP was correlated with higher uACR levels and a risk of albuminuria in middle age, especially in women. The identification and control of cumulative SBP levels from an early age may assist in reducing the incidences of renal and cardiovascular disease for individuals in later life.
蛋白尿被认为是心血管和肾脏疾病的预测因子。我们旨在确定收缩压的长期负担和趋势对中年时期蛋白尿的影响，并探讨这种关系的性别差异。
这项纵向研究包括 1683 名成年人，他们在儿童时期开始接受了 4 次或更多次血压检查，随访时间为 30 年。通过使用个体收缩压测量的曲线下面积（AUC）的增长曲线随机效应模型来确定血压的累积效应和纵向趋势。
在 30 年的随访期间，有 190 人发生了蛋白尿，其中男性占 53.2%，女性占 46.8%（最近一次随访时年龄为 43.39±3.13 岁）。尿白蛋白/肌酐比值（uACR）值随着总 AUC 和增量 AUC 值的增加而增加。此外，女性在高 SBP AUC 组中的蛋白尿发生率高于男性（男性为 13.3%，女性为 33.7%）。Logistic 回归显示，高总 AUC 组中男性和女性发生蛋白尿的 OR 分别为 1.34（0.70-2.60）和 2.94（1.50-5.74）。在增量 AUC 组中也发现了类似的关联。
较高的累积 SBP 与较高的 uACR 水平和中年时期蛋白尿的风险相关，尤其是在女性中。从早期识别和控制累积 SBP 水平可能有助于降低个体晚年患肾脏和心血管疾病的风险。
