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慢性阻塞性肺疾病(COPD)患者的尿白蛋白-肌酐比值(ACR):一项横断面研究。

Urine Albumin-Creatinine Ratio (ACR) of Patients With Chronic Obstructive Pulmonary Disease (COPD): A Cross-Sectional Study.

作者信息

Laha Souradip, Mohapatra Amrut, Sarangi Rajlaxmi, Sahoo Jyoti Prakash, Subhankar Saswat

机构信息

Pulmonary Medicine, Kalinga Institute of Medical Sciences, Bhubaneswar, IND.

Biochemistry, Kalinga Institute of Medical Sciences, Bhubaneswar, IND.

出版信息

Cureus. 2025 Jun 29;17(6):e86974. doi: 10.7759/cureus.86974. eCollection 2025 Jun.

Abstract

Background and objectives Chronic obstructive pulmonary disease (COPD) and chronic kidney disease (CKD) may coexist. Their co-occurrence and impacts on renal and pulmonary functions have not been explored in detail. We planned this study to evaluate urine albumin-creatinine ratio (ACR) levels among patients with COPD. We also assessed the correlation among age, urine ACR, forced expiratory volume in 1 second (FEV), Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage, and COPD Assessment Test (CAT) score of the participants. Methods This cross-sectional study was conducted at Kalinga Institute of Medical Sciences (KIMS), Bhubaneswar, India, from March 2023 to April 2025. The following parameters were noted from the case sheets after admission: age, serum creatinine, urine albumin, urine creatinine, urine ACR, FEV, forced vital capacity (FVC), FEV/FVC, GOLD stage, and CAT score. We correlated all these values. We used R software (version 4.4.3; R Foundation for Statistical Computing, Vienna, Austria) for data analysis. Results Three hundred fifty-seven patients were recruited for the study. The median age of the participants was 61.0 years (54.0-69.0 years). 233 (65.3%) participants were males. The median serum creatinine was 1.97 mg/dL (0.81-2.48 mg/dL). The study population's median urine ACR was 24.59 mg/g (10.83-50.13 mg/g). The median FEV was 46.79% (39.78-60.72%) of the predicted value. The median FEV/FVC was 0.57 (0.53-0.60). According to the GOLD staging, most individuals fell into stages 2 (134, 37.5%) and 3 (156, 43.7%). The median CAT score was 18.0 (14.0-21.0). There were positive associations between GOLD stage and CAT score (r = 0.767, p < 0.001), age and GOLD stage (r = 0.673, p < 0.001), and age and CAT score (r = 0.622, p < 0.001). There were negative associations between GOLD stage and FEV (r = -0.945, p < 0.001), age and FEV/FVC (r = -0.851, p < 0.001), FEV and CAT score (r = -0.755, p < 0.001), and age and FEV (r = -0.736, p < 0.001). The significant correlations with urine ACR were found with GOLD stage (r = 0.409, p < 0.001), CAT score (r = 0.310, p < 0.001), FEV (r = -0.357, p < 0.001), and FEV/FVC (r = -0.229, p < 0.001). Conclusion Urine ACR and CAT scores were higher among the elderly population. With aging, FEV readings decreased. Our study showed weak correlations between the lung parameters and urine ACR.

摘要

背景与目的 慢性阻塞性肺疾病(COPD)和慢性肾脏病(CKD)可能并存。它们的共同出现及其对肾脏和肺功能的影响尚未得到详细研究。我们开展本研究以评估COPD患者的尿白蛋白-肌酐比值(ACR)水平。我们还评估了参与者的年龄、尿ACR、一秒用力呼气容积(FEV)、慢性阻塞性肺疾病全球倡议(GOLD)分级以及COPD评估测试(CAT)评分之间的相关性。方法 本横断面研究于2023年3月至2025年4月在印度布巴内斯瓦尔的卡林加医学科学研究所(KIMS)进行。入院后从病历中记录以下参数:年龄、血清肌酐、尿白蛋白、尿肌酐、尿ACR、FEV、用力肺活量(FVC)、FEV/FVC、GOLD分级和CAT评分。我们对所有这些值进行相关性分析。我们使用R软件(版本4.4.3;奥地利维也纳的R统计计算基金会)进行数据分析。结果 357名患者被纳入本研究。参与者的中位年龄为61.0岁(54.0 - 69.0岁)。233名(65.3%)参与者为男性。中位血清肌酐为1.97mg/dL(0.81 - 2.48mg/dL)。研究人群的中位尿ACR为24.59mg/g(10.83 - 50.13mg/g)。中位FEV为预测值的46.79%(39.78 - 60.72%)。中位FEV/FVC为0.57(0.53 - 0.60)。根据GOLD分级,大多数个体处于2期(134例,37.5%)和3期(156例,43.7%)。中位CAT评分为18.0(14.0 - 21.0)。GOLD分级与CAT评分之间存在正相关(r = 0.767,p < 0.001),年龄与GOLD分级之间存在正相关(r = 0.673,p < 0.001),年龄与CAT评分之间存在正相关(r = 0.622,p < 0.001)。GOLD分级与FEV之间存在负相关(r = -0.945,p < 0.001),年龄与FEV/FVC之间存在负相关(r = -0.851,p < 0.001),FEV与CAT评分之间存在负相关(r = -0.755,p < 0.001),年龄与FEV之间存在负相关(r = -0.736,p < 0.001)。发现尿ACR与GOLD分级(r = 0.409,p < 0.001)、CAT评分(r = 0.310,p < 0.001)、FEV(r = -0.357,p < 0.001)和FEV/FVC(r = -0.229,p < 0.001)之间存在显著相关性。结论 老年人群的尿ACR和CAT评分较高。随着年龄增长,FEV读数下降。我们的研究表明肺参数与尿ACR之间存在弱相关性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39cc/12306697/1de698c4110b/cureus-0017-00000086974-i01.jpg

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