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Published on: June 16, 2014
Relationship between high-normal albuminuria and arterial stiffness in Chinese population
Chaoyi Ye1,2, Jin Gong1,2,3, Tingjun Wang1,3
1Department of Geriatrics, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.
Insights
High-normal albuminuria, indicated by elevated urinary albumin-to-creatinine ratio (UACR), is linked to arterial stiffness in Chinese adults. This finding suggests high-normal albuminuria may be an early marker for cardiovascular disease risk.
Area of Science:
- Cardiovascular Disease Research
- Nephrology
- Biomarkers
Background:
- High-normal albuminuria is associated with cardiovascular disease morbidity and mortality.
- Arterial stiffness is a recognized predictor of cardiovascular disease.
- The relationship between high-normal albuminuria and arterial stiffness in the Chinese population remains unclear.
Purpose of the Study:
- To investigate the association between high-normal albuminuria and arterial stiffness in a Chinese cohort.
- To identify predictors of arterial stiffness in individuals with varying levels of albuminuria.
Main Methods:
- A cross-sectional study included 1343 Chinese participants (mean age 58.9 years).
- Urinary albumin-to-creatinine ratio (UACR) categorized participants into low-normal, high-normal, microalbuminuria, and macroalbuminuria groups.
- Arterial stiffness was measured using carotid-femoral pulse wave velocity (cfPWV).
Main Results:
- Carotid-femoral pulse wave velocity (cfPWV) increased progressively with higher UACR levels (P < .001).
- Logarithmically transformed UACR (LG-UACR) was independently associated with cfPWV in all participants.
- This association persisted in high-normal albuminuria subgroups, particularly in males, individuals over 65, and normotensives.
Conclusions:
- Elevated UACR within the high-normal range is associated with increased arterial stiffness.
- High-normal albuminuria may serve as an early indicator of arterial stiffness, especially in specific Chinese subpopulations.
- Age and blood pressure remain the most significant risk factors for arterial stiffness.
Abstract:
High-normal albuminuria is related to the morbidity and mortality of cardiovascular disease. Arterial stiffness has been regarded as a predictor of cardiovascular disease. However, the relationship between high-normal albuminuria and arterial stiffness is uncertain in Chinese population. A total of 1343 Chinese participants (aged 58.9 ± 12.1 years, 63.53% male) were included in this study. High-normal albuminuria was defined as urinary albumin-to-creatinine ratio (UACR) above the median within normal albuminuria. Based on the level of UACR, all participants were divided into low-normal albuminuria group (UACR < 6.36 mg/g, n = 580), high-normal albuminuria group (6.36 mg/g ≤ UACR < 30 mg/g, n = 581), microalbuminuria (30 mg/g ≤ UACR < 300 mg/g, n = 162), and macroalbuminuria (UACR ≥ 300 mg/g, n = 20). Arterial stiffness was assessed by measuring carotid-femoral pulse wave velocity (cfPWV). With the increment of UACR, the level of cfPWV was increased gradually (P < .001). Stepwise multiple regression analysis showed that systolic blood pressure, age, serum creatinine, heart rate, logarithmic (LG)-transformed UACR, and fasting plasma glucose were independently associated with cfPWV in all subjects (P < .001). LG-UACR was found to be related to cfPWV in high-normal albuminuria and macroalbuminuria subjects. After further stratification in the high-normal albuminuria subjects, their relation remained in male, elderly over 65 years old, or normotensives. In summary, UACR is associated with arterial stiffness in subjects with proteinuria excretion in high normal level. High-normal albuminuria might be an early indicator of arterial stiffness, especially in male, elderly, or normotensives in Chinese population. Furthermore, age and blood pressure are still observed to be the most important risk factor of arterial stiffness.
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