J Cardiovasc Ultrasound.  2010 Dec;18(4):134-138. 10.4250/jcu.2010.18.4.134.

Urine Albumin Creatinine Ratio is Associated with Carotid Atherosclerosis in a Community Based Cohort: Atherosclerosis Risk of Rural Area in Korean General Population Study

• Sung JK
• Kim JY
• Youn YJ
• Lee JW
• Ahn SG
• Yoo BS
• Lee SH
• Yoon J
• Choe KH
• Yoon JH
• Park JK
• Koh SB

• KMID: 2177314
• DOI: http://doi.org/10.4250/jcu.2010.18.4.134

Abstract

BACKGROUND
Albuminuria is a surrogate marker of endothelial dysfunction and a predictor of cardiovascular events. Data are limited with regard to the relationship between albuminuria and subclinical atherosclerosis in a community-based cohort. We determined the association between albuminuria measured by the urine albumin creatinine ratio (UACR) and carotid intima media thickness (CIMT) in a Korean rural population.
METHODS
We enrolled 1,369 healthy subjects older than 40 years (857 males and 518 females) with normal renal function and measured the CIMT. We excluded subjects with overt proteinuria (> 300 mg/day) or with treatment of diabetes mellitus, hypertension, dyslipidemia, and any cardiovascular disease. The subjects were stratified into the quartile value of the UACR (lowest quartile: UACR < 4.8 and highest quartile: UACR > 17.7). And we evaluate the relationship between UACR and CIMT by linear regression and logistic regression analysis.
RESULTS
Increasing quartile of the UACR had a stepwise increase in body mass index, blood pressure, cholesterol profile [low density lipoprotein (LDL)-cholesterol and triglyceride], glucose, homeostratic model assessment of insulin resistance (HOMA-IR), and C-reactive protein (all p values < 0.001). Maximal CIMT from the 1st to the 4th quartile values of the UACR were 0.74 +/- 0.17, 0.77 +/- 0.18, 0.78 +/- 0.18, and 0.82 +/- 0.21 mm, respectively (p < 0.001). In a multivariate regression model adjusted for age, sex, systolic blood pressure, triglyceride, LDL-cholesterol, fasting blood sugar, waist circumference, adiponectin, HOMA-IR, high sensitive C-reactive protein, smoking, UACR showed a significant association with maximal CIMT (B = 0.014, R2 = 0.145, p = 0.002).
CONCLUSION
Albuminuria measured by the UACR was significantly associated with both CIMT and traditional risk factors of atherosclerosis except for smoking in healthy Koreans.

Keyword

Urine albumin creatinine ratio; Carotid intima-media thickness

MeSH Terms

Adiponectin
Albuminuria
Atherosclerosis
Biomarkers
Blood Glucose
Blood Pressure
Body Mass Index
C-Reactive Protein
Cardiovascular Diseases
Carotid Artery Diseases
Carotid Intima-Media Thickness
Cholesterol
Cohort Studies
Creatinine
Diabetes Mellitus
Dyslipidemias
Fasting
Glucose
Humans
Hypertension
Insulin Resistance
Linear Models
Lipoproteins
Logistic Models
Male
Proteinuria
Risk Factors
Smoke
Smoking
Waist Circumference
Adiponectin
Blood Glucose
C-Reactive Protein
Cholesterol
Creatinine
Glucose
Lipoproteins
Smoke

Figure

• 

  Fig. 1 Odd ratios of carotid atherosclerosis according to quartile groups of UACR. *p < 0.001, †p < 0.05. UACR: urine albumin creatinine ratio.

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