Relation of urinary albumin excretion to coronary heart disease and low renal function: Role of blood pressure

Cirillo, Massimo; Laurenzi, Martino; Panarelli, Paolo; Mancini, Mario; Zanchetti, Alberto; Santo, Natale G. De

doi:10.1111/j.1523-1755.2004.00652.x

Cited by 25 publications

(23 citation statements)

References 38 publications

(42 reference statements)

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“…CHD was analyzed as the most common clinical presentation of vascular disease 11 and defined with use of ECG data combined with symptoms reported in the questionnaire as described previously. 8 Myocardial infarction or ischemia were combined in analysis, because previous data showed that uAE is similarly and independently related to both disorders. 8 Data of skinfold thickness (triceps and subscapular) and weight were used for the estimation of fat mass.…”

Section: Methodsmentioning

confidence: 99%

“…8 Myocardial infarction or ischemia were combined in analysis, because previous data showed that uAE is similarly and independently related to both disorders. 8 Data of skinfold thickness (triceps and subscapular) and weight were used for the estimation of fat mass. 12 Nonfat mass was calculated as weight minus fat mass.…”

Section: Methodsmentioning

confidence: 99%

“…Descriptive data on smoking, hypercholesterolemia, diabetes mellitus, infarction, and ischemia were reported previously. 4,7,8 Differences between men and women were significant for weight, fat mass, nonfat mass, urinary creatinine, and microalbuminuria prevalence. Urinary creatinine excretion correlated with weight and nonfat mass (Rϭ0.403 and 0.504; PϽ0.001) but not with fat mass (Rϭ0.022; Pϭ 0.379).…”

Section: Descriptive Statisticsmentioning

confidence: 98%

“…Significant and independent associations were reported previously among uAE, cardiovascular risk factors, and coronary heart disease (CHD) in middle-age persons participating in the Gubbio Population Study. 4,7,8 Data of the Gubbio Study were analyzed to investigate persons with high uACR and normal uAE, that is, on the elevation of the uACR because of low urinary creatinine excretion rather than high uAE. Analyses were focused on the prevalence of this trait, its association with CHD, and indices of body mass.…”

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confidence: 99%

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Low Muscular Mass and Overestimation of Microalbuminuria by Urinary Albumin/Creatinine Ratio

et al. 2006

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Abstract-Microalbuminuria is a mild urinary albumin elevation and is associated with cardiovascular disease. Urinary albumin/creatinine ratio is recommended for microalbuminuria assessment, because it reflects urinary albumin excretion. Muscular mass could affect albumin/creatinine ratio, because urinary creatinine reflects muscular mass. The study investigated high albumin/creatinine ratio attributed to low urinary creatinine without microalbuminuria. The Gubbio Population Study for ages 45 to 64 collected data on weight, skinfold, urinary albumin, urinary creatinine, and coronary heart disease. Weight and skinfold thickness were used to calculate fat and nonfat mass and urinary creatinine as a marker of muscular mass. Microalbuminuria was defined as urinary albumin of 20 to 199 g/min and high albumin/creatinine ratio as a ratio of 17 to 250 g/mg in men and of 25 to 355 g/mg in women. Persons with macroalbuminuria (urinary albumin Ն200 g/min) were excluded to focus analyses on microalbuminuria. Coronary heart disease was defined by ECG and questionnaire. The target cohort consisted of 1623 men and women, ages 45 to 64. Prevalence was 8.5% for high albumin/creatinine ratio (nϭ138), 4.3% for microalbuminuria (nϭ69), 5.2% for high albumin/creatinine ratio without microalbuminuria (nϭ85), and 1.0% for nonhigh albumin/creatinine ratio with microalbuminuria (nϭ16). High albumin/creatinine ratio without microalbuminuria was inversely associated with nonfat mass and urinary creatinine (PϽ0.04). Compared with persons with a nonhigh albumin/creatinine ratio, coronary heart disease was more prevalent in persons with a high albumin/creatinine ratio and microalbuminuria (18.9% and 7.1%; Pϭ0.002), not in persons with a high albumin/creatinine ratio without microalbuminuria (8.2% and 7.1%; Pϭ0.706). A high albumin/creatinine ratio in persons with low muscle mass indicates low urinary creatinine more often than microalbuminuria and cardiovascular disease. Key Words: albuminuria Ⅲ body mass Ⅲ muscles Ⅲ coronary disease A statement of the American Heart Association and guidelines of the National Kidney Foundation suggest that the moderate elevation in urinary albumin excretion (uAE) defined as microalbuminuria should be considered as a risk factor for cardiovascular disease. 1,2 The urinary albumin/creatinine ratio (uACR) is recommended for the assessment of uAE, because uACR is an index of uAE than can be measured in untimed spot urine samples. In fact, the uACR can be calculated with use of the urinary concentration of albumin and creatinine without information on duration and volume of urine collection. The value of the uACR necessarily depends not only on the rate of uAE but also on the rate of urinary creatinine excretion that, in turn, reflects the interindividual differences in muscle mass. 3,4 Gender-specific thresholds for the definition of high uACR were proposed to reduce the confounding because of an underestimate of microalbuminuria, that is, a normal uACR because of the combination of high uAE with high urinary cre...

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Descriptive Statisticsmentioning

confidence: 98%

mentioning

confidence: 99%

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Low Muscular Mass and Overestimation of Microalbuminuria by Urinary Albumin/Creatinine Ratio

et al. 2006

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“…In the Prevention of Renal and Vascular End-Stage Disease (PREVEND) study conducted in nondiabetic residents of the city of Groningen (the Netherlands), it was observed that GFR estimated by 24-h creatinine clearance tended to be elevated in subjects with high-normal AER (15-30 mg/day), whereas macroalbuminuria was independently associated with a reduction in creatinine clearance below values expected for age and sex (4). In the Gubbio study conducted in a sample of an Italian community of 1,632 subjects aged 45-64 years, no relationship between increasing AER and the prevalence of "low" creatinine clearance (Ͻ60 ml/min) was found (31).…”

Section: Albuminuria and Renal Outcomes In Essentialmentioning

confidence: 99%

Microalbuminuria in Type 2 Diabetes and Hypertension

et al. 2008

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Definition of Kidney Dysfunction as a Cardiovascular Risk Factor<subtitle>Use of Urinary Albumin Excretion and Estimated Glomerular Filtration Rate</subtitle>

Cirillo

Lanti²,

Menotti³

et al. 2008

Arch Intern Med

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Background: Urinary albumin excretion (UAE) and estimated glomerular filtration rate (eGFR) have been used separately to provide information about cardiovascular risk. We analyzed whether UAE and eGFR used together provide complementary information.Methods: We analyzed UAE, eGFR, cardiovascular risk factors, and incidence of cardiovascular disease in 1665 men and women of the Gubbio Population Study (aged 45-64 years). We designated UAE in the highest decile as high (Ն18.6 µg/min in men and Ն15.7 µg/min in women) and eGFR in the lowest decile as low (Ͻ64.20 mL/min/1.73 m 2 in men and Ͻ57.90 mL/min/1.73 m 2 in women).Results: Kidney dysfunction defined using both markers was more frequent than using 1 marker (UAE alone or eGFR alone) (P Ͻ .001) because high UAE and low eGFR clustered in different individuals and were weakly associated with each other (P=.12). The hazard ratio (HR) for incident cardiovascular disease was elevated for both markers, independently of each other (HR for high UAE,

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Relation of urinary albumin excretion to coronary heart disease and low renal function: Role of blood pressure

Abstract: Results support the use of urinary albumin excretion as marker of CHD and slightly reduced renal function in hypertensives.

Cited by 25 publications

References 38 publications

Low Muscular Mass and Overestimation of Microalbuminuria by Urinary Albumin/Creatinine Ratio

Low Muscular Mass and Overestimation of Microalbuminuria by Urinary Albumin/Creatinine Ratio

Microalbuminuria in Type 2 Diabetes and Hypertension

Definition of Kidney Dysfunction as a Cardiovascular Risk Factor<subtitle>Use of Urinary Albumin Excretion and Estimated Glomerular Filtration Rate</subtitle>

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