社区老年人群尿微量白蛋白/尿肌酐比值与心血管病危险因素的关系

目的 研究社区65岁及以上老年人群尿微量白蛋白/尿肌酐比值(UACR)现况及其与心血管病危险因素的关系.方法 对"十一五"国家科技支撑计划"慢性心力衰竭早期预警和失代偿期综合防治的研究"的社区队列研究中一个农村社区所有65岁及以卜老年人进行包括心血管病危险因素在内的基线情况调查,并留取清晨点时间尿样检测尿微量白蛋白、尿肌酐和UACR等,分析UACR在健康人群以及具有心血管病危险因素人群中的分布情况.结果 (1)完成调查的65岁及以上老年人共1718名,其中男性721名,女性997名,年龄(73.3±5.5)岁.(2)调查的老年人群中,有至少1种心血管病危险因素者占78.00%,患病率排在前3位的心血管病危险凶素依次是血脂异常、高血压和糖尿病,其患病率分别为61.06%、44.59%和13.80%.(3)健康人群UACR中位数为13.81(6.03～26.51)μg/mg,其中男性为5.49(2.92～9.76)μg/mg,女性为17.12(7.28～33.28)μg/mg,女性显著高于男性(P<0.01).(4)具有高血压、糖尿病和血脂异常人群的UACR分别为16.27(6.65～42.00)μg/mg、26.27(10.92～76.65)μg/mg和16.39(6.98～41.03)μg/mg,均高于健康人群(P<0.05或P<0.01).(5)具有0、1、2,3和4个心血管病危险因素人群的UACR中位数分别为13.81(6.03～26.51)μg/mg、15.76(6.79～36.44)μg/mg、13.82(5.68～34.43)μg/mg、16.47(6.07～50.56)μg/mg和18.63(11.26～83.09)μg/mg,具有4个危险因素人群的UACR水平显著高于无危险因素人群(P<0.05).结论 65岁及以上社区老年人群患病率排在前3位的心血管病危险因素依次是血脂异常、高血压和糖尿病,三者均与UACR增高有关.

Abstract：

objective To determine the value of the urinary microalbumin/creatinine ratio (UACR)and the relationship between UACR and traditional cardiovascular risk factors among elderly community subjects.Methods A representative population in Shanghai rural district aged more than 65years who participated in the heart health survey of the key projects in the national science and technology pillar program in the eleventh five-year plan period of China were sampled via a clustered complex sampling method.A midstream collection from the first morning void collected was used to measure the urinary microalbumin,the urinary creatinine and the UACR.Baseline information including traditional cardiovascular risk factors were obtained by standard questionaire to analyze the distribution status of UACR in the population with or without the risk factors.Results (1)There were 1718 subjects(721 males)of(73.3±5.5)years included in this study.(2)The prevalence of with at least one cardiovascular risk factor was 78.00%in this cohort,the top there risk factors were dyslipidemia(61.06%),hypertension(44.59%)and diabetes(13.80%).(3)The median(the lower quartile-the upper quartile)of the UACR of the population without cardiovascular diseases and risk factors was 13.81(6.03-26.51)μg/mg.The level of UACR was significantly higher in females than that in males[17.12(7.28-33.28)μg/mg vs.5.49(2.92-9.76)μg/mg,P<0.01].(4) The level of UACR in population with hypertension,diabetes or dyslipidemia was 16.27(6.65-42.00)μg/mg,26.27(10.92-76.65)μg/mg and 16.39(6.98-41.03)μg/mg respectively,all exceeding that of the healthy group(P<0.05 or P<0.01).(5)The levels of UACR increased in proportion to the increase of cardiovascular risk factor numbers, the UACR of the population with 0, 1,2, 3 and 4 cardiovascular risk factors were 13. 81 (6. 03 - 26. 51 ) μg/mg, 15.76(6.79-36.44)μg/mg, 13.82 (5.68-34.43) μg/mg, 16.47 (6.07-50.56) μg/mg and 18.63( 11.26 - 83.09 ) μg/mg, respectively. The population with 4 cluster of cardiovascular risk factors posed the higher level of UACR than that of population with 0 cardiovascular risk factors ( P < 0. 05 ). Conclusions The three most common risk factors of cardiovascular diseases among the elderly community subjects aged more than 65 years are dyslipidemia, hypertension and diabetes, all of which are related to the elevation of UACR.

Association between the urinary microalbumin/creatinine ratio and cardiovascular risk factors among elderly community subjects

objective To determine the value of the urinary microalbumin/creatinine ratio (UACR)and the relationship between UACR and traditional cardiovascular risk factors among elderly community subjects.Methods A representative population in Shanghai rural district aged more than 65years who participated in the heart health survey of the key projects in the national science and technology pillar program in the eleventh five-year plan period of China were sampled via a clustered complex sampling method.A midstream collection from the first morning void collected was used to measure the urinary microalbumin,the urinary creatinine and the UACR.Baseline information including traditional cardiovascular risk factors were obtained by standard questionaire to analyze the distribution status of UACR in the population with or without the risk factors.Results (1)There were 1718 subjects(721 males)of(73.3±5.5)years included in this study.(2)The prevalence of with at least one cardiovascular risk factor was 78.00%in this cohort,the top there risk factors were dyslipidemia(61.06%),hypertension(44.59%)and diabetes(13.80%).(3)The median(the lower quartile-the upper quartile)of the UACR of the population without cardiovascular diseases and risk factors was 13.81(6.03-26.51)μg/mg.The level of UACR was significantly higher in females than that in males[17.12(7.28-33.28)μg/mg vs.5.49(2.92-9.76)μg/mg,P<0.01].(4) The level of UACR in population with hypertension,diabetes or dyslipidemia was 16.27(6.65-42.00)μg/mg,26.27(10.92-76.65)μg/mg and 16.39(6.98-41.03)μg/mg respectively,all exceeding that of the healthy group(P<0.05 or P<0.01).(5)The levels of UACR increased in proportion to the increase of cardiovascular risk factor numbers, the UACR of the population with 0, 1,2, 3 and 4 cardiovascular risk factors were 13. 81 (6. 03 - 26. 51 ) μg/mg, 15.76(6.79-36.44)μg/mg, 13.82 (5.68-34.43) μg/mg, 16.47 (6.07-50.56) μg/mg and 18.63( 11.26 - 83.09 ) μg/mg, respectively. The population with 4 cluster of cardiovascular risk factors posed the higher level of UACR than that of population with 0 cardiovascular risk factors ( P < 0. 05 ). Conclusions The three most common risk factors of cardiovascular diseases among the elderly community subjects aged more than 65 years are dyslipidemia, hypertension and diabetes, all of which are related to the elevation of UACR.