The urine albumin-creatinine ratio is a predictor for incident long-term care in a general population

Takahashi, Shuko; Tanaka, Fumitaka; Yonekura, Yuki; Tanno, Kozo; Ohsawa, Masaki; Sakata, Kiyomi; Koshiyama, Makoto; Okayama, Akira; Nakamura, Motoyuki

doi:10.1371/journal.pone.0195013

Cited by 8 publications

(8 citation statements)

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“…An elevated level of the urinary albumin to creatinine ratio (UACR) is not only a marker of renal dysfunction but also has been described as an independent predictor of cardiovascular disease in diabetic [1, 2] and non-diabetic patients [3, 4]. Moreover, recent findings have indicated that the UACR is more closely associated with diabetic retinopathy than the estimated glomerular filtration rate (eGFR) [5] and might be valuable in evaluating the risk for cognitive decline [6, 7]. Additionally, a robust body of literature has demonstrated that moderately increased albuminuria (UACR less than 30 mg/g) within the accepted normal range is associated with higher cardiovascular morbidity and mortality even in the general population [8, 9].…”

Section: Introductionmentioning

confidence: 99%

Elevated triglycerides rather than other lipid parameters are associated with increased urinary albumin to creatinine ratio in the general population of China: a report from the REACTION study

Wang

et al. 2019

Cardiovasc Diabetol

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Background Dyslipidaemia has always been regarded as the cornerstone of arteriosclerosis and is related to the pathogenesis of renal insufficiency. However, it is unclear which routinely available lipid parameter is related to urinary albumin to creatinine ratio (UACR). The purpose of this study was to examine the lipid abnormalities associated with UACR in the general population in China. Methods The present study was nested in an ongoing Risk Evaluation of cAncers in Chinese diabetic Individuals: A lONgitudinal (REACTION) study, which was designed to demonstrate the association of abnormal glucose metabolism with the risk of cancer in the Chinese population. This cross-sectional study included 34, 569 subjects (11, 390 males and 23, 179 females) from 8 different regional community cohorts, with an average age of 57.9 years. The UACR data were divided into the < 25% group, the 25–49% group, the 50–74% group, and the ≥ 75% group according to the quartile division of the centre where the subjects visited. The lipid classes were defined according to the guidelines for the prevention and treatment of dyslipidaemia in Chinese adults. Multiple logistic regression analysis was used to evaluate the association of the lipid parameters and UACR. Results Multivariable regression analysis revealed that compared with the other lipid parameters, triglycerides (TG) showed an adjusted odds ratio that was significant in model 1–4. This relationship was attenuated after adjusting for Haemoglobin A1c (HbA1c) and blood pressure (BP), but TG ≥ 2.3 mmol/L was still significantly associated with UACR in total subjects and in both men and women (OR: 1.131, 95% CI 1.065–1.203, P < 0.001 in total subjects; OR: 1.134, 95% CI 1.022–1.258, P = 0.017 in men; OR: 1.129, 95% CI 1.046–1.219, P = 0.002 in women). In the stratified analysis, elevated TG was significantly associated with increased urinary albumin in subjects with eGFR ≥ 90 mL/min per 1.73 m 2 , 5.6 ≤ FBG < 7.0 or 7.8 ≤ PBG < 11.1 mmol/L, 24 ≤ BMI < 28 kg/m 2 , 120 ≤ SBP < 140 and/or 80 ≤ DBP < 90 mmHg. Conclusions We conclude that high TG levels rather than total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, or non-high-density lipoprotein cholesterol levels are associated with UACR in the general population in China. Electronic supplementary material The online version of this article (10.1186/s12933-019-0863-8) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Elevated triglycerides rather than other lipid parameters are associated with increased urinary albumin to creatinine ratio in the general population of China: a report from the REACTION study

Wang

et al. 2019

Cardiovasc Diabetol

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“…High IL-6 plasma levels are associated with functional impairment in elderly individuals with vascular dementia [55]. A previous study showed that albuminuria predicted future functional disability [29]. Given these findings, poor SRH might be an alternative index of functional disability with physical impairment and cognitive dysfunction caused by asymptomatic brain infarction or endothelial dysfunction.…”

Section: Discussionmentioning

confidence: 99%

“…Body mass index was calculated as body weight [kg] divided by the square of height [m]. Blood pressure, anthropometric data, results of blood tests (serum levels of total cholesterol (TC; mg/dl), high-density lipoprotein cholesterol (HDLC; mg/dl), non-high-density lipoprotein cholesterol (non-HDLC; mg/dl), hemoglobin (Hb; g/dl), and glycosylated hemoglobin (HbA1c; %)), and estimated glomerular filtration rate (eGFR; mL/min/1.73 m 2 ) were used for analysis [ 24 , 29 ]. Participants answered a self-reported questionnaire that was prepared by the study committee.…”

Section: Methodsmentioning

confidence: 99%

“…According to each level, applicants can receive the services covered by the fee for each service. Functional disability in any of the levels above LTCI items was defined as the endpoint [29]. .…”

Section: Endpoint Measurementmentioning

confidence: 99%

“…Sleep duration was categorized into 3 groups: ≤ 6 h per day, 7-8 h per a day, ≥ 9 h per day. Clinical cardiovascular (CV) risk factors in three diseases (hypertension, diabetes mellitus and dyslipidemia) were assessed [29]. Hypertension was defined as systolic blood pressure of 140 mmHg or higher and/or diastolic blood pressure of 90 mmHg or higher, and/or the use of medications for a hypertensive state.…”

Section: Endpoint Measurementmentioning

confidence: 99%

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Poor self-rated health predicts the incidence of functional disability in elderly community dwellers in Japan: a prospective cohort study

et al. 2020

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Background Although previous large population studies showed elderly with poor self-rated health (SRH) to be at a high risk of functional disability in Western countries, there have been few studies in which the association between SRH and functional disability was investigated in Japanese community dwellers. The association between SRH and functional disability, defined as certification of the long-term care insurance (LTCI) system, in Japanese elderly community dwellers was examined in this study. Methods A total of 10,690 individuals (39.5% men, mean age of 71.4 years) who were 65 years of age or more who did not have a history of cardiovascular disease or LTCI certification were followed in this prospective study for 10.5 years. SRH was classified into four categories: good, rather good, neither good nor poor, and poor. A Cox proportional-hazards model was used to determine the hazard ratios (HRs) for the incidence of functional disability among the SRH groups for each sex. Results The number of individuals with functional disability was 3377. Men who rated poor for SRH scored significantly higher for functional disability (HR [95% confidence interval]: poor = 1.74 [1.42, 2.14]) while women who rated rather good, neither good nor poor, and poor scored significantly higher for functional disability (rather good =1.12 [1.00, 1.25], neither good nor poor = 1.29 [1.13, 1.48], poor = 1.92 [1.65, 2.24]: p for trend < 0.001 in both sexes). Conclusion Self-rated health, therefore, might be a useful predictor of functional disability in elderly people.

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Sex differences in the contribution of different physiological systems to physical function in older adults

et al. 2021

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Having the physical function to undertake activities of daily living (ADLs) is essential in order to maintain independence. The aim of this study is to investigate factors associated with physical function in older adults and determine if these associations differ in men versus women. In total, 726 participants (57% men; 73±7 years old) from a population-based cohort, the Southall and Brent Revisited (SABRE) study, completed questionnaires permitting a physical function score (PFS) to be calculated. Detailed phenotyping was performed including cardiovascular (echocardiography and macrovascular and microvascular functions), skeletal muscle (grip strength and oxidative capacity) and lung (pulmonary) function measurements. In a sub-group, maximal aerobic capacity was estimated from a sub-maximal exercise test. In women versus men, the association between grip strength and PFS was nearly 3 times stronger, and the association between microvascular dysfunction and PFS was over 5 times stronger (standardized β-coefficient (95% CI) 0.34 (0.22, 0.45) versus 0.11 (0.01,0.22) and −0.27 (−0.37, −0.17) versus −0.05 (−0.14, 0.04), respectively). In men, the association between cardiorespiratory fitness and PFS was 3 times greater than that in women (standardized β-coefficient (95% CI) 0.33 (0.22, 0.45) versus 0.10 (−0.04, 0.25). Cardiovascular, skeletal muscle and pulmonary factors all contribute to self-reported physical function, but the relative pattern of contribution differs by sex. Grip strength and microvascular function are most strongly associated with physical function in women while cardiorespiratory fitness is most strongly associated with physical function in men. This is relevant to the design of effective interventions that target maintenance of physical function in old age.

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The urine albumin-creatinine ratio is a predictor for incident long-term care in a general population

Cited by 8 publications

References 24 publications

Elevated triglycerides rather than other lipid parameters are associated with increased urinary albumin to creatinine ratio in the general population of China: a report from the REACTION study

Elevated triglycerides rather than other lipid parameters are associated with increased urinary albumin to creatinine ratio in the general population of China: a report from the REACTION study

Poor self-rated health predicts the incidence of functional disability in elderly community dwellers in Japan: a prospective cohort study

Sex differences in the contribution of different physiological systems to physical function in older adults

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