Department of Pediatrics, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, P.O. Box 30.001 - CA13, 9700RB, Groningen, The Netherlands.
Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700RB, Groningen, The Netherlands.
Eur J Pediatr. 2023 Nov;182(11):4921-4929. doi: 10.1007/s00431-023-05152-4. Epub 2023 Aug 22.
In adults, albuminuria represents a risk factor for cardiovascular disease and is associated with hypertension and obesity. Pediatric data from the general population are inconsistent and largely based on randomly collected urine. A possible association between antenatal programming and albuminuria at school age has still to be investigated. The purpose of this study is to assess albuminuria in first morning void urine samples in a population-based pediatric cohort and to investigate cross-sectionally the association with factors related to cardiovascular risk. Moreover, we investigate the possible association of antenatal factors with albuminuria. A first morning void urine sample was collected in the population-based GECKO (Groningen Expert Center for Kids with Obesity) Drenthe cohort at the age of 12 years. We investigated cross-sectionally associations between albuminuria and body mass index (BMI), waist circumference (WC), blood pressure (BP) and antenatal factors. The prevalence of U (urinary albumin-creatinine ratio) ≥ 3 mg/mmol was 3.3% (95%CI 2.3-4.2). In a multivariate linear regression model, U was negatively associated with z-BMI (β-0.08, p = 0.013) and positively with z-systolic BP (β 0.09, p = 0.006), model significance p = 0.002. U was negatively associated with z-BMI (β - 0.13, p < 0.001) and positively with z-diastolic BP (β 0.09, p = 0.003), model significance p = 0.001. Albuminuria was not significantly associated with antenatal factors such as gestational age and standardized birth weight.
Albuminuria in first morning void urine in 12-year-olds has a lower prevalence than previously reported by randomly collected samples. A negative association between albuminuria and BMI is confirmed. A positive association with blood pressure, but no association with antenatal factors was found.
• While, in adults, albuminuria is a recognized risk factor for cardiovascular disease and is associated with hypertension and obesity, pediatric data are inconsistent and largely based on randomly collected urine. • A possible association between antenatal programming and albuminuria at school age has still to be investigated.
• In this population study on first morning void urine samples from 12-year-olds of the general population, albuminuria is negatively associated with body mass index, and positively associated with blood pressure, while there is no association with antenatal factors. • The prevalence of albuminuria at 12 years is lower than previously reported in studies based on randomly collected urine samples, probably due to elimination of orthostatic proteinuria.
评估基于人群的儿科队列中首次晨尿样本中的白蛋白尿，并横断面研究其与心血管风险相关因素的关系。此外，我们还研究了产前因素与白蛋白尿的可能关联。
在基于人群的格罗宁根儿童肥胖专家中心（GECKO）德伦特队列中，于 12 岁时收集首次晨尿样本。我们横断面研究了白蛋白尿与体重指数（BMI）、腰围（WC）、血压（BP）和产前因素之间的关系。
U（尿白蛋白/肌酐比值）≥3mg/mmol 的患病率为 3.3%（95%CI 2.3-4.2）。在多元线性回归模型中，U 与 z-BMI 呈负相关（β-0.08，p=0.013），与 z-收缩压呈正相关（β 0.09，p=0.006），模型意义 p=0.002。U 与 z-BMI 呈负相关（β-0.13，p<0.001），与 z-舒张压呈正相关（β 0.09，p=0.003），模型意义 p=0.001。白蛋白尿与胎龄和标准化出生体重等产前因素无显著相关性。
12 岁儿童首次晨尿中的白蛋白尿患病率低于以前随机采集尿液样本的报告。证实了白蛋白尿与 BMI 呈负相关。发现与血压呈正相关，但与产前因素无相关性。
