Gould M M, Mohamed-Ali V, Goubet S A, Yudkin J S, Haines A P
Department of Primary Health Care and Medicine, University College and Middlesex School of Medicine, Whittington Hospital, London.
BMJ. 1993 Jan 23;306(6872):240-2. doi: 10.1136/bmj.306.6872.240.
To study the association(s) between microalbuminuria and cardiovascular risk factors in non-diabetic subjects.
Patients aged 40-75 years were randomly selected from a general practice list and invited to participate.
Health centre in inner city London.
Of those invited, 1046 out of 1671 (62.6%) attended. Subjects were excluded for the following reasons: not being white (44); urinary albumin excretion rate > 200 micrograms/min (3); having a urinary infection (5); taking penicillamine or angiotensin converting enzyme inhibitors (7); older than 75 (2); having diabetes (25); missing data on glucose concentration (1).
Glucose tolerance test results, albumin excretion rate from overnight and timed morning collections of urine; blood pressure; height.
Mean albumin excretion rate was significantly lower in women than men (mean ratio 0.8, 95% confidence interval (0.69 to 0.91)). Mean albumin excretion rate was significantly associated with age, blood pressure, and blood glucose concentration (fasting, 1 hour, and 2 hour) in men and inversely with height. Men who had microalbuminuria in both samples were significantly shorter (by 5 cm (1.3 to 9.3 cm)) than those who had no microalbuminuria in either sample when age was taken into account. In the case of women only systolic pressure was significantly associated with albumin excretion rate.
Microalbuminuria and short stature in men are associated. Cardiovascular risk has been associated with both of these factors and with lower birth weight. The inverse association of microalbuminuria with height is compatible with the suggestion that factors operating in utero or early childhood are implicated in cardiovascular disease. The higher prevalence of microalbuminuria in men compared with women may indicate that sex differences in cardiovascular risk are reflected in differences in albumin excretion rate.
研究非糖尿病患者微量白蛋白尿与心血管危险因素之间的关联。
从一份全科医疗名单中随机选取40 - 75岁的患者并邀请其参与。
伦敦市中心的健康中心。
受邀者中,1671人中有1046人(62.6%)参加。因以下原因排除研究对象:非白人(44人);尿白蛋白排泄率>200微克/分钟(3人);患有泌尿系统感染(5人);正在服用青霉胺或血管紧张素转换酶抑制剂(7人);年龄超过75岁(2人);患有糖尿病(25人);血糖浓度数据缺失(1人)。
葡萄糖耐量试验结果、过夜及定时晨尿尿白蛋白排泄率;血压;身高。
女性的平均白蛋白排泄率显著低于男性(平均比值0.8,95%置信区间(0.69至0.91))。男性的平均白蛋白排泄率与年龄、血压和血糖浓度(空腹、1小时及2小时)显著相关,与身高呈负相关。在考虑年龄因素后,两个样本中均有微量白蛋白尿的男性比两个样本中均无微量白蛋白尿的男性显著矮5厘米(1.3至9.3厘米)。仅在女性中,收缩压与白蛋白排泄率显著相关。
男性微量白蛋白尿与身材矮小有关。心血管风险与这两个因素以及较低的出生体重均有关联。微量白蛋白尿与身高的负相关与子宫内或幼儿期起作用的因素与心血管疾病有关的观点相符。男性微量白蛋白尿的患病率高于女性,这可能表明心血管风险的性别差异反映在白蛋白排泄率的差异上。