【摘 要】
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Objective The relationship between changes in proteinuria and myocardial infarction (MI) remain unclear in people with diabetes or prediabetes.We aimed to evaluate the predictive value and independent
【机 构】
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Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical Universit
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Objective The relationship between changes in proteinuria and myocardial infarction (MI) remain unclear in people with diabetes or prediabetes.We aimed to evaluate the predictive value and independent role of changes in proteinuria over two-year period in the incidence of MI in people with diabetes or prediabetes.Methods We used a large Chinese population from the Kailuan prospective study to determine the association between changes in proteinuria over two-year period and risk of MI.Based on the baseline and 2-year dipstick screening results,participants were divided into 4 categories: no proteinuria,remittent proteinuria,incident proteinuria,and persistent proteinuria.Four multivariable Cox proportional hazard models were built to adjust for the effects of different confounding covariates.Results 17625 participants were finally included in this study.There were a total of 238 incidence of MI during a median follow-up of 6.69 years.After adjustment for demography factors and laboratory indexes,the association between persistent proteinuria and MI morbidity were maintained (hazard ratio[HR]2.50,95% confidence interval[CI]1.48 to 4.22).And each decrease of proteinuria from 2006 to 2008 was responsible for 21% decline of MI morbidity (HR 0.79,95% CI 0.68 to 0.90).The interaction between changes in proteinuria and diabetes was confirmed with no effect on MI (P=0.3371).Conclusions Persistent proteinuria is an independent risk factor for incident MI in either diabetic or prediabetic population.These findings may help clinicians to interpret proteinuria changes in the outpatient setting and give more attention on prevention for people with prediabetes or diabetes.
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