Albuminuria, metabolic syndrome and the risk of mortality and cardiovascular events

Solbu, Marit Dahl; Kronborg, Jens; Jenssen, Trond; Njølstad, Inger; Løchen, Maja‐Lisa; Mathiesen, Ellisiv B.; Wilsgaard, Tom; Eriksen, Bjørn Odvar; Toft, Ingrid

doi:10.1016/j.atherosclerosis.2008.11.002

Cited by 45 publications

(36 citation statements)

References 28 publications

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“…A chronic low-grade albuminuria has been noted in patients with MetS without diabetes mellitus 32,33 , which could explain the lower albumin serum levels in patients with MetS. These lower serum albumin levels could also be due to decreased hepatic albumin synthesis or to increased albumin catabolism associated with chronic inflammation 34 .…”

Section: Discussionmentioning

confidence: 98%

Frequency of metabolic syndrome and the food intake patterns in adults living in a rural area of Brazil

Silva¹,

Prata²,

Cunha³

2011

Rev. Soc. Bras. Med. Trop.

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Introduction: Metabolic syndrome (MetS), a risk factor for atherosclerosis and coronary heart disease, is related to an inadequate food intake pattern. Its incidence is increasing among Brazilian adults, including those living in rural areas. Our aim was not only to describe the frequency of MetS in adults with or without MetS but also to compare their food intake pattern as assessed by the healthy eating index (HEI) and serum albumin and C reactive protein (CRP) levels. Methods: Men and women (n = 246) living in a small village in Brazil were included. MetS was characterized according to the adult treatment panel (ATP III) criteria. Groups were compared by chi-square, student t or Mann-Whitney tests. Results: MetS was diagnosed in 15.4% of the cases. The MetS group showed higher CRP (1.8±1.2 vs. 1.0±0.9 mg/dl) and lower albumin (4.3±0.3 vs. 4.4±0.3 g/dl) serum levels compared to the control group. Additionally, the MetS group showed lower scores (median[range]) in the HEI compared to the control group (53.5[31.2-78.1] vs 58[29.7-89.5], respectively). The MetS group also had decreased scores for total fat and daily variety of food intake. Conclusions: The results suggest that adults with MetS displayed chronic mild inflammation and a poorer food intake pattern than the control group.

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Section: Discussionmentioning

confidence: 98%

Frequency of metabolic syndrome and the food intake patterns in adults living in a rural area of Brazil

Silva¹,

Prata²,

Cunha³

2011

Rev. Soc. Bras. Med. Trop.

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“…Among 13 estimates, 6 derived from the general population, [15][16][17][18]22,23 5 from a Type 2 DM population, 13,14,16,19,20 and 2 from a population with a stroke history. 12,21 Nine studies were from a white-dominant population, [12][13][14][15][16][17][18][19]22 2 from an Asian population, 20,21 and 1 from an American Indian population. 23 The participant number ranged from 370 21 to 23 433.…”

Section: Resultsmentioning

confidence: 99%

Impact of Microalbuminuria on Incident Stroke

Lee

Saver²,

Chang³

et al. 2010

Stroke

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Background and Purpose-Microalbuminuria, a marker of both kidney disease and endothelial dysfunction, may be associated with global vascular risk, but the nature and magnitude of the link between microalbuminuria and incident stroke has not been clearly defined. The purpose of this study was to assess the consistency and strength of the association of microalbuminuria with risk of stroke in prospective studies using meta-analysis. Methods-We conducted a systematic search of electronic databases and bibliographies for studies reporting a multivariate-adjusted estimate, represented as relative risk with 95% CI, of the association between microalbuminuria and stroke risk. Studies were excluded if a majority of study participants had established kidney disease or pre-eclampsia. Estimates were combined using a random-effect model. Results-We identified 12 studies, with a total of 48 596 participants and 1263 stroke events. Overall, presence of microalbuminuria was associated with greater stroke risk (relative risk, 1.92; 95% CI, 1.61 to 2.28; PϽ0.001) after adjustment for established cardiovascular risk factors. There was evidence of significant heterogeneity in the magnitude of the association across studies (P for heterogeneity Ͻ0.001, I

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“…11,[13][14][15] In the present study, however, eGFR was not associated with any end point, perhaps due to the narrow distribution of eGFR within the normal range in a relatively healthy population. 12,30 Notwithstanding the lack of improved risk prediction exhibited by the NAG ratio, the independent significant associations between the NAG ratio and clinical events may shed some light upon possible pathophysiological processes linking renal dysfunction and CVD, and may thus encourage further research focused on these issues. Albuminuria is considered to be the result of generalized endothelial dysfunction, 31 and is shown to coexist with cardiovascular risk factors such as higher age, obesity, hypertension, early disturbances in glucose metabolism, and diabetes.…”

Section: Discussionmentioning

confidence: 99%

“…10 UAE is a well established risk factor for development of both cardiovascular disease (CVD) and renal disease. [11][12][13][14][15] However, the mechanisms mediating this risk have not yet been fully established. 10 It is conceivable that tubular markers may further explain the linkage between renal dysfunction including UAE and CVD.…”

mentioning

confidence: 99%

N-Acetyl-β-D-Glucosaminidase Does Not Enhance Prediction of Cardiovascular or All-Cause Mortality by Albuminuria in a Low-Risk Population

Solbu

Toft

Løchen

et al. 2016

Journal of the American Society of Nephrology

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Albuminuria is a well known risk factor for cardiovascular disease and mortality, but focus on renal tubular dysfunction as a potential risk factor is growing also. The association between the urinary activity of N-acetylb-D-glucosaminidase (NAG) and cardiovascular risk has been assessed mostly in cross-sectional studies. We studied the cross-sectional associations between urinary NAG and cardiovascular risk factors and the longitudinal associations between NAG, cardiovascular disease, and all-cause mortality in a general population. Urinary NAG/creatinine ratio (NAG ratio) and albumin/creatinine ratio (ACR) were measured in 6834 participants of the Tromsø Study in 1994-1995. During the median 17.5 years of follow-up, 958 myocardial infarctions, 726 ischemic strokes, and 2358 deaths were registered. In multivariable analyses adjusted for albuminuria and cardiovascular risk factors, a baseline NAG ratio in the highest quartile was associated with an increased risk of myocardial infarction (hazard ratio [HR], 1.43; 95% confidence interval [95% CI], 1.16 to 1.76), ischemic stroke (HR, 1.41; 95% CI, 1.10 to 1.80), and all-cause mortality (HR, 1.60; 95% CI, 1.39 to 1.84). Combined, ACR and NAG ratio above median associated with a 48%-80% increased risk for the three end points. However, the NAG ratio did not add significantly to the baseline risk-prediction models when assessed by area under the receiver operating characteristics curve or net reclassification improvement. In conclusion, the nonsignificant improvement of risk prediction does not support the clinical use of NAG ratio in cardiovascular risk assessment in a low-risk group.

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Albuminuria, metabolic syndrome and the risk of mortality and cardiovascular events

Cited by 45 publications

References 28 publications

Frequency of metabolic syndrome and the food intake patterns in adults living in a rural area of Brazil

Frequency of metabolic syndrome and the food intake patterns in adults living in a rural area of Brazil

Impact of Microalbuminuria on Incident Stroke

N-Acetyl-β-D-Glucosaminidase Does Not Enhance Prediction of Cardiovascular or All-Cause Mortality by Albuminuria in a Low-Risk Population

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