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目的:探讨上海郊区非糖尿病人群中低水平清蛋白尿与肱踝脉搏波传导速度(baPWV)的相关性。方法:在上海市嘉定区选取1 548名正常清蛋白尿[尿清蛋白/肌酐(UACR)<30 mg/g]的非糖尿病居民,对其进行问卷调查、体格检查、血和尿的生化检测以及baPWV检测,分析人群UACR水平与baPWV的相关性。结果:①按UACR值四分位分组,随着UACR水平的升高,UACR下四分位组到上四分位组的baPWV值分别为(1 459±280)、(1 506±311)、(1 554±349)、(1 621±349)cm/s;动脉硬化患病率分别为51.93%(202/389)、57.25%(221/386)、65.03%(251/386)、71.32%(276/387),组间趋势明显(趋势P<0.000 1)。②Pearson相关分析显示,baPWV与UACR呈显著正相关(r=0.190,P<0.000 1)。③多元Logistic回归分析显示,校正年龄、性别、体质量指数、糖化血红蛋白A1c、总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、估测肾小球滤过率、高血压、目前吸烟、目前饮酒、是否大量运动等传统心血管影响因素后,与下四分位组相比,UACR位于第2、第3及上四分位组患动脉硬化的风险逐渐增高,比值比(OR)[95%可信区间(CI)]分别为1.50(1.04～2.15)、1.63(1.12～2.36)和1.67(1.13～2.49),趋势P=0.030 4。结论:非糖尿病人群中,UACR在参考范围内的微量增加与baPWV升高明显相关,低水平清蛋白尿是非糖尿病人群动脉硬化的独立危险因素。
Objective: To investigate the correlation between low level albuminuria and brachial-ankle pulse wave velocity (baPWV) in non-diabetic population in Shanghai suburbs. Methods: A total of 1 548 non-diabetic residents with normal albuminuria (urinary albumin / creatinine (UACR) <30 mg / g] were enrolled in the Jiading District of Shanghai. Questionnaires, physical examination, biochemical tests of blood and urine And baPWV detection, analysis of population UACR levels and baPWV correlation. Results: ① According to the UACR quartiles, the baPWV values of the UACR quartile to the upper quartile were (1 459 ± 280), (1 506 ± 311), The prevalence of atherosclerosis was 51.93% (202/389), 57.25% (221/386), 65.03% (251/386), 71.32% (276/387), with a significant trend between groups (trend P <0.000 1). ②Pearson correlation analysis showed that there was a significant positive correlation between baPWV and UACR (r = 0.190, P <0.0001). ③ Logistic regression analysis showed that age, gender, body mass index, glycosylated hemoglobin A1c, total cholesterol, triglyceride, high density lipoprotein cholesterol, low density lipoprotein cholesterol, estimated glomerular filtration rate, , Current smoking, current alcohol intake, whether a large number of exercise and other traditional cardiovascular factors, compared with the lower quartile, UACR located in the second, third and upper quartile with atherosclerosis risk increased gradually, the odds ratio (OR) [95% confidence interval (CI)] were 1.50 (1.04-2.15), 1.63 (1.12-2.36) and 1.67 (1.13-2.49), respectively, with a trend of P = 0.0304. CONCLUSION: In non-diabetic patients, the slight increase of UACR in the reference range is significantly associated with the increase of baPWV. Low-grade albuminuria is an independent risk factor for atherosclerosis in non-diabetic subjects.