Jensen J S, Borch-Johnsen K, Feldt-Rasmussen B, Appleyard M, Jensen G
Steno Diabetes Center, Gentofte, Denmark.
J Cardiovasc Risk. 1997 Apr;4(2):121-5.
Preliminary studies have suggested that microalbuminuria--a slightly increased urinary excretion of albumin--is a risk factor for atherosclerosis. The aim of this study was to examine whether an association exists between urinary excretion of albumin and a history of acute myocardial infarction, in a major population sample.
The study was performed as a part of the 3rd Copenhagen City Heart Study, Denmark, 1992-1994, and included 2,613 participants aged 30-70 years, and without diabetes mellitus, renal or urinary tract disease or haematuria. The study programme included measurement of urinary albumin excretion rate, acquisition of information regarding previous acute myocardial infarction (verified by the Danish Hospital Register) and tobacco and alcohol consumption, 12-lead resting electrocardiogram, and measurement of blood pressure, body mass index, waist:hip ratio, plasma concentrations of total cholesterol, HDL cholesterol and fibrinogen, serum albumin concentration and glomerular filtration rate.
Among the participants, 3.6% presented with a history of acute myocardial infarction. There was a positive association between urinary albumin excretion rate (logarithmically transformed) and acute myocardial infarction (odds ratio 1.35, 95% confidence interval 1.08 to 1.70, n = 2, 613; P = 0.01), which was independent of age, sex conventional atherosclerotic risk factors, and glomerular filtration rate. The odds ratio for acute myocardial infarction associated with microalbuminuria (urinary albumin excretion rate exceeding the upper decile in the entire study population) was 2.06 (95% confidence interval 1.20 to 3.55, n = 2,613; P = 0.009).
There exists a positive and independent association between urinary excretion of albumin and a history of acute myocardial infarction. Follow-up analyses should determine the time sequence of this association.
初步研究表明，微量白蛋白尿（即尿白蛋白排泄略有增加）是动脉粥样硬化的一个危险因素。本研究的目的是在一个主要人群样本中，检验尿白蛋白排泄与急性心肌梗死病史之间是否存在关联。
该研究作为1992 - 1994年丹麦第三次哥本哈根市心脏研究的一部分进行，纳入了2613名年龄在30 - 70岁之间、无糖尿病、肾脏或泌尿系统疾病或血尿的参与者。研究项目包括测量尿白蛋白排泄率、获取有关既往急性心肌梗死（经丹麦医院登记册核实）以及烟草和酒精消费的信息、12导联静息心电图，以及测量血压、体重指数、腰臀比、总胆固醇、高密度脂蛋白胆固醇和纤维蛋白原的血浆浓度、血清白蛋白浓度和肾小球滤过率。
在参与者中，3.6%有急性心肌梗死病史。尿白蛋白排泄率（对数转换）与急性心肌梗死之间存在正相关（比值比1.35，95%置信区间1.08至1.70，n = 2613；P = 0.01），这与年龄、性别、传统动脉粥样硬化危险因素和肾小球滤过率无关。与微量白蛋白尿（尿白蛋白排泄率超过整个研究人群的上十分位数）相关的急性心肌梗死的比值比为2.06（95%置信区间1.20至3.55，n = 2613；P = 0.009）。
尿白蛋白排泄与急性心肌梗死病史之间存在正相关且独立的关联。后续分析应确定这种关联的时间顺序。
