Abstract
Background
Microalbuminuria is associated with cardiovascular disease (CVD). We investigated
whether low-grade albuminuria (LGA) is independently associated with the carotid intima-media
thickness (CIMT) and carotid plaques in normotensive and euglycemic Chinese middle-aged
and elderly adults.
Methods
A total of 1341 normotensive and euglycemic participants (489 males and 852 females;
mean age, 57.7 years) with normal urinary albumin-to-creatinine ratios (UACRs) (＜30 μg/mg)
were enrolled from the Changfeng Study. A standard interview, anthropometric measurements
and laboratory analyzes were performed for each participant. Bilateral CIMTs were
measured using ultrasonography, and the presence of carotid plaques was assessed.
The urinary albumin excretion rate was measured using an early morning urine sample
to determine the UACR.
Results
The median UACRs were 4.2 (interquartile range, 2.9–6.0) μg/mg and 5.6 (interquartile
range, 4.0–8.2) μg/mg for male and female subjects, respectively. Compared with subjects
with UACRs in the first and second tertiles, subjects of both genders with UACRs in
the third tertile had greater CIMTs. After adjusting for conventional CVD risk factors
and the glomerular filtration rate (GFR), male and female participants with UACRs
in the third tertile for each gender had a 1.696-fold and 1.911-fold increased risk,
respectively, of carotid plaques relative to those in the lowest tertiles. The logUACR
was positively associated with the CIMT (β = 0.068 in males, P = 0.001; and β = 0.034 in females, P = 0.012) after adjusting for conventional CVD risk factors and the GFR. The multiple
logistic regression analysis showed that a 1-unit increase in the logUACR corresponded
to an odds ratio (OR) of having a carotid plaque that was 1.875 (95% confidence interval
(CI) 1.103–3.538; P = 0.022) and 2.389 (95% CI 1.244–4.391; P = 0.01) for male and female subjects, respectively, after adjusting for all potential
confounders.
Conclusions
These results suggest that the UACR is independently associated with carotid atherosclerosis
in normotensive and euglycemic Chinese individuals and that even when well below the
current microalbuminuria threshold, LGA contributes to the risk of atherosclerosis.
Highlights
- The study was conducted in a population with normal glucose tolerance and without hypertension.
- The UACR was independently associated with carotid atherosclerosis after adjusting for CVD risk factors.
- The UACR in the normal range is a novel marker or risk factor for atherosclerosis.
Keywords
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Article info
Publication history
Published online: March 04, 2013
Accepted:
February 3,
2013
Received in revised form:
January 14,
2013
Received:
September 7,
2012
Identification
Copyright
© 2013 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
