社区人群尿白蛋白/肌酐比值与血管早衰的关系研究

Relationship Between Urinary Albumin to Creatinine Ratio and Premature Vascular Aging in Community Population

目的探讨社区人群尿白蛋白/肌酐比值(UACR)与血管早衰的关系。方法选取2021年11—12月在宿州市南关街道社区卫生服务中心进行体检的常住居民为调查对象。调查体检人员一般资料,采集体检人员体格检查信息(体质量、BMI)、肱踝动脉脉搏波传导速度(baPWV)(左上肢baPWV、右上肢baPWV)、血压〔收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)〕、实验室检查指标〔空腹血糖(FPG)、糖化血红蛋白(HbA_(1c))、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、血肌酐(Scr)、尿白蛋白(UA)、尿肌酐(Ucr)、尿微量白蛋白(mAlb)、UACR及UACR异常情况〕。使用华中科技大学同济医院根据Framingham研究开发的血管年龄计算器计算血管年龄。社区人群血管早衰的影响因素分析采用多因素Logistic回归分析;两指标间的相关性分析采用Spearman秩相关分析。结果792例体检人员中血管早衰433例(血管早衰组),血管逆龄359例(血管逆龄组)。血管早衰组男性占比、高血压发生率、糖尿病发生率、吸烟者占比、体质量、BMI、SBP、DBP、MAP、FPG、HbA_(1c)、TC、TG、LDL-C、Scr、UA、mAlb、UACR、UACR异常者占比高于血管逆龄组,年龄小于血管逆龄组,左上肢baPWV、右上肢baPWV快于血管逆龄组,HDL-C低于血管逆龄组(P<0.05)。多因素Logistic回归分析结果显示,性别、BMI、高血压、TC、TG、UACR异常是社区人群血管早衰的独立影响因素(P<0.05)。Spearman秩相关分析结果显示,社区人群UACR异常与血管年龄呈正相关(r_(s)=0.131,P=0.002)。亚组分析结果显示,在女性、吸烟和无糖尿病的社区人群中,UACR异常与血管早衰有关(P<0.05)。结论UACR异常是社区人群血管早衰的影响因素,UACR异常与女性、吸烟和无糖尿病的社区人群血管早衰相关,UACR可能成为血管早衰的重要预测指标。

Objective To explore the relationship between the urinary albumin to creatinine ratio(UACR)and the premature vascular aging in community population.Methods Permanent residents who underwent health examinations at the Nanguan Street Community Health Service Center in Suzhou City from November to December 2021 were selected as survey subjects.General information of the examinees was investigated,and physical examination data(body weight,BMI),brachialankle pulse wave velocity(baPWV)(left upper limb baPWV,right upper limb baPWV),blood pressure[systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial pressure(MAP)],and laboratory examination indicators[fasting plasma glucose(FPG),glycosylated hemoglobin(HbA_(1c)),total cholesterol(TC),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),serum creatinine(Scr),urinary albumin(UA),urinary creatinine(Ucr),urinary microalbumin(mAlb),UACR,and abnormal UACR]were collected.Vascular age was calculated using the vascular age calculator developed by Tongji Hospital of Huazhong University of Science and Technology based on the Framingham study.Multivariate Logistics regression analysis was used to analyze the influencing factors of vascular premature aging in community population.Spearman rank correlation analysis was used to analyze the correlation between the two indicators.Results Among 792 examinees,433 cases had premature vascular aging(premature vascular aging group)and 359 had reverse vascular aging(reverse vascular aging group).The proportion of males,the incidence of hypertension,the incidence of diabetes,the proportion of smokers,body weight,BMI,SBP,DBP,MAP,FPG,HbA_(1c),TC,TG,LDL-C,Scr,UA,mAlb,UACR,and the proportion of abnormal UACR in the premature vascular aging group were higher than those in the reverse vascular aging group,and age was younger than that in the reverse vascular aging group,the baPWV of the left upper limb and the baPWV of the right upper limb were faster than those in the reverse vascular aging group,and HDL-C was lower than that in the reverse vascular aging group(P<0.05).Multivariate Logistic regression analysis showed that gender,BMI,hypertension,TC,TG,and abnormal UACR were independent influencing factors of premature vascular aging in community population(P<0.05).Spearman rank correlation analysis showed that abnormal UACR was positively correlated with vascular age in community population(r_(s)=0.131,P=0.002).Subgroup analysis showed that in female,smoking,and non-diabetic examinees,abnormal UACR was associated with premature vascular aging(P<0.05).Conclusion Abnormal UACR is an influencing factor of premature vascular aging in community population.Abnormal UACR is related to premature vascular aging in female,smoking and non-diabetic community population.UACR may become an important predictor of premature vascular aging.