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背景高血压前期和尿白蛋白均与心血管病危险有关,然而二者之间的关系国内还少有报道。目的了解不同血压水平与尿白蛋白之间是否有独立的关联关系。方法在北京市首钢社区整群随机抽取40岁以上人群2500人,实际调查2315人。收集清晨首次尿标本,测量尿白蛋白和肌酐,计算尿白蛋白肌酐比(UACR)作为尿白蛋白的指标,以30、300mg/g为切点,将尿白蛋白水平分为三级,由低到高依次为正常、微量、显性白蛋白尿。将研究对象按血压水平分为3组,分别为正常血压组、高血压前期和高血压组。同时调查心血管病危险因素。使用多变量累积比数logistic回归模型调整混杂因素,分析不同血压水平与尿白蛋白水平的关联。结果研究人群中微量、显性白蛋白尿发生率分别为7.8%和1.5%。调整混杂因素后,与正常血压相比,高血压前期者患有更高水平尿白蛋白的OR为1.0[95%CI0.6～1.7];高血压的OR为2.6(95%CI1.5～4.6)。结论高血压前期与尿白蛋白水平无独立相关关系,而高血压则独立相关。
Background Prehypertension and urinary albumin are associated with the risk of cardiovascular disease, but the relationship between the two is still rarely reported in China. Objective To understand whether there is an independent relationship between different blood pressure levels and urinary albumin. Methods A total of 2 500 people over the age of 40 were randomly selected from the entire cluster of Beijing Shougang Group, with 2,315 actually investigated. Urine albumin and creatinine were measured for the first time in the morning. Urinary albumin creatinine ratio (UACR) was calculated as an index of urinary albumin. Urine albumin level was divided into three levels by 30,300 mg / g, Low to high followed by normal, trace, dominant albuminuria. Subjects were divided into three groups according to their blood pressure levels: normotensive group, prehypertensive group and hypertensive group. Simultaneous investigation of cardiovascular risk factors. Multivariate logistic regression models were used to adjust for confounding factors and to analyze the association of different blood pressure levels with urinary albumin levels. Results The micro- and dominant albuminuria rates in the study population were 7.8% and 1.5%, respectively. After adjusting for confounding factors, the OR for patients with prehypertension who had higher levels of urinary albumin was 1.0 [95% CI 0.6-1.7] and hypertension was 2.6 (95% CI 1.5-5) compared with normotensive subjects 4.6). Conclusion There is no independent correlation between prehypertension and urinary albumin, but hypertension is independent.