Low‐grade albuminuria is associated with high cardiovascular risk in <scp>CVD</scp> ‐free and normoalbuminuric Chinese adults: Results from the <scp>REACTION</scp> study

Data are limited with regard to the association between low-grade albuminuria (below the threshold of microalbuminuria) and high cardiovascular risk in normoalbuminuric Chinese adults free of cardiovascular disease (CVD).A total of 32 650 participants aged over 40 years from seven regional centers in China were included in this study. The single-void first morning urine sample was collected to measure the urinary albumin to creatinine ratio (UACR) and the data were divided into sex-specific quartiles. The Framingham Risk Score (FRS) was used to identify participants at high risk of developing coronary heart disease (CHD) over the next 10 years and the association between low-grade albuminuria and high 10-year Framingham risk for CHD (FRS ≥20%) was investigated.Among males and females, the prevalence of cardiometabolic risk factors (diabetes, hypertension, and dyslipidemia) increased markedly with the elevation of UACR quartiles. Logistic regression analysis showed that the odds ratios (ORs) for high 10-year risk of CHD increased significantly from the second quartile in males (UACR: 4.78 ~ 7.53 mg/g, OR = 1.21, 95% confidence interval [CI]: 1.05-1.40) and the third quartile in females (UACR: 9.13 ~ 15.04 mg/g, OR = 3.07, 95% CI: 1.75-5.40). Stratified analysis showed that in males, the association was especially pronounced in elderly, overweight/obese participants and those without diabetes and hypertension whereas in females, the association was especially pronounced in elderly, overweight/obese participants and those without diabetes and with hypertension.Low-grade albuminuria was significantly associated with high 10-year cardiovascular risk among CVD-free and normoalbuminuric Chinese adults.背景: 在无心血管疾病(CVD)且尿蛋白正常的中国成年人群中, 关于低度白蛋白尿(低于微量白蛋白尿阈值)与心血管高危风险的相关性研究数据有限。 方法: 本研究共纳入来自中国7个中心的32650名40岁以上社区人群。收集晨尿测尿微量白蛋白与肌酐的比值(UACR), 分别在男性和女性中进行数据分析, 并根据UACR水平将各性别人群分成四分位。采用Framingham风险评分(FRS)计算参与者未来10年罹患冠心病(CHD)的风险, FRS ≥ 20%者被定义为未来10年患冠心病的风险为高危。建立Logistic回归模型, 分析低度白蛋白尿与未来10年冠心病高危风险的相关性。 结果: 在男性和女性中, 冠心病高危因素如糖尿病、高血压和血脂异常的患病率随着UACR水平的升高而显著增加。Logistic回归分析显示, 从男性UACR第二分位(UACR: 4.78 ~ 7.53 mg/g, OR = 1.21, 95% [CI]: 1.05-1.40)、女性第三分位(UACR:9.13 ~ 15.04 mg/g, OR = 3.07, 95% CI: 1.75-5.40)开始, 随着UACR的升高, 未来10年冠心病高危风险的比值比(OR)明显增加。分层分析显示, 在老年、超重或肥胖、无糖尿病和无高血压的男性以及老年、超重或肥胖、无糖尿病和有高血压的女性中, 这种相关性最为显著。 结论: 在无心血管疾病病史且尿蛋白正常的中国成年人群中, 低度白蛋白尿与未来10年冠心病高危风险显著相关。.