普通人群微量白蛋白尿与心血管疾病危险因素的关系

Association between microalbuminuria and cardiovascular risk factors in general population

目的分析24 h微量白蛋白尿(MAU)与心血管疾病危险因素的相关性。方法采用多阶段整群随机抽样方法,研究对象来自2013年10月至2014年3月居住在山东和江苏省4个县的2400名居民,年龄18~69岁。检测所有入选者24 h MAU,比较不同人群微量白蛋白尿发生率,分析危险因素聚集与尿微量白蛋白的关系。采用多因素Logistic回归法分析影响MAU发生的危险因素。结果2265名调查对象纳入研究,其中有MAU者203例,发生率为8.96%(203/2265,95%CI:7.82~10.21),肥胖、高血压、糖尿病、高三酰甘油(TG)血症和低高密度脂蛋白血症人群MAU发生率分别为14.65%(63/430)、12.53%(104/830)、20.22%(36/178)、15.57%(64/411)和11.99%(53/442),明显高于相对应健康人群,组间比较差异有统计学意义(均P<0.01)。多因素Logistic回归分析结果显示,肥胖、高血压、糖尿病和高TG血症为发生MAU的危险因素,OR(95%CI)分别为1.491(1.016~2.265)、1.660(1.190~2.314)、2.291(1.494~3.515)、1.734(1.205~2.495)。随着危险因素聚集个数增加,尿微量白蛋白水平和发生率都呈现上升趋势。结论肥胖、高血压、糖尿病和高TG血症等心血管疾病危险因素是影响MAU发生的危险因素。

Objective To investigate the association between microalbuminuria and cardiovascular risk factors in a general Chinese population.Methods A multi-stage cluster randomized sampling method was used to select 2400 residents (18-69 years old) in four counties in Shandong and Jiangsu provinces in October 2013 to March 2014. 24-hour MAU were measured for each subject. The prevalence of MAU in different groups was analyzed. The relationship between the aggregation of risk factors and MAU was analyzed. Logistic regression analysis was used to evaluate the association between MAU and cardiovascular risk factors.Results A total of 2265 subjects were included in the analysis. The prevalence of MAU was 8.96%(203/2265, 95%CI: 7.82-10.21). The prevalence of MAU in obesity, hypertension, diabetes, hypertriglyceridemia, and low HDL-C group were 14.65%(63/430), 12.53%(104/830), 20.22%(36/178), 15.57%(64/411), 11.99%(53/442) respectively, which were significantly higher than the corresponding healthy population (all P<0.01). Multivariate logistic regression analysis showed that obesity, hypertension, diabetes, and hypertriglyceridemia were risk factors for MAU. The OR(95%CI) values were 1.491(1.016-2.265), 1.660(1.190-2.314), 2.291(1.494-3.515) and 1.734(1.205-2.495) respectively. With the increase in the number of influencing factors, urinary albumin levels and the prevalence of MAU all showed an upward trend.Conclusion MAU was associated with cardiovascular risk factors such as obesity, hypertension, diabetes, and hypertriglyceridemia.