中国35岁以上居民白蛋白尿流行状况及心血管疾病风险分析  

Prevalence of albuminuria and its association with cardiovascular diseases in Chinese residents aged over 35 years

作　　者：顾润清 郑聪毅 张林峰[2] 陈祚[2] 王馨[2] 曹雪 田奕欣 陈露 周好奇 陈晨[2] 胡真 宋于心 邵澜[2] 田野[2] 王增武[1,2] Gu Runqing;Zheng Congyi;Zhang Linfeng;Chen Zuo;Wang Xin;Cao Xue;Tian Yixin;Chen Lu;Zhou Haoqi;Chen Chen;Hu Zhen;Song Yuxin;Shao Lan;Tian Ye;Wang Zengwu(School of Population Medicine and Public Health,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China;Division of Prevention and Community Health,Fuwai Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,National Center for Cardiovascular Diseases,Beijing 102308,China)

机构地区：[1]中国医学科学院北京协和医学院群医学及公共卫生学院,北京100730 [2]北京协和医学院中国医学科学院阜外医院、国家心血管病中心社区防治部,北京102308

出　　处：《中华内科杂志》2023年第3期290-296,共7页Chinese Journal of Internal Medicine

基　　金：国家“十二五”科技支撑计划 (2011BAI11B01)。

摘　　要：目的探讨中国35岁以上居民白蛋白尿现患情况及其对心血管疾病(CVD)的影响。方法横断面研究。2012年至2015年在中国采用分层多阶段随机抽样方法纳入34647名研究对象(年龄≥35岁),通过调查问卷、体格检查和生化指标检测等方法收集所需的资料。将尿白蛋白与尿肌酐的比值<30 mg/g定义为正常,30~300 mg/g为微量白蛋白尿(MAU),≥300 mg/g为大量白蛋白尿。计量资料以x¯±s表示,采用t检验进行指标间的比较。定性资料采用率或构成比表示,采用χ^(2)检验或Kruskal-Wallis检验。多因素分析采用logistic回归。运用SAS 9.4软件进行统计学分析,双侧检验,P<0.05为差异有统计学意义。结果异常白蛋白尿的患病率为19.1%;其中MAU为17.2%,男女分别为13.8%和20.1%;女性显著高于男性(P<0.01)。相较于白蛋白尿正常的人群,MAU者(OR=1.23,95%CI 1.12~1.35)、大量白蛋白尿者(OR=1.86,95%CI 1.50~2.32)患CVD的风险会增加;同时伴有高血压、糖尿病的MAU者患CVD的风险增加1.76倍。结论MAU患病率高,受累人群多。MAU增加了患CVD风险,尤其是伴有高血压、糖尿病的患者。Objective To investigate the prevalence of albuminuria in Chinese residents aged>35 years and its potential association with cardiovascular disease(CVD).Methods A total of 34647 Chinese subjects aged≥35 years were selected by stratified multi-stage random sampling from 2012 to 2015.Data were collected through questionnaires,physical examinations,and laboratory tests.Albuminuria was categorized into 3 types according to urinary albumin-to-creatinine ratio:normal(<30 mg/g),microalbuminuria(MAU,30-300 mg/g),and macroalbuminuria(≥300 mg/g).Measurement data were expressed as x¯±s,and t-tests were used for comparisons between indicators.Qualitative data were expressed as rate or constituent ratio,and the χ^(2) test or Kruskal-Wallis test was used to examine differences.Logistic regression was used for multivariate analyses.SAS 9.4 software was used for statistical analyses,and P<0.05 was considered statistically significant.Results The prevalence of abnormal albuminuria was 19.1%;the prevalence was 17.2%for MAU and lower in males(13.8%)than females(20.1%,P<0.01).The risk of CVD was higher among subjects with MAU(OR=1.23,95%CI 1.12-1.35)and macroalbuminuria(OR=1.86,95%CI 1.50-2.32).When MAU was complicated by hypertension and diabetes mellitus,the CVD risk was 1.76 times higher.Conclusions The prevalence of MAU is high among Chinese subjects aged 35 years and over.Those with MAU have higher CVD risk,especially those with hypertension and diabetes mellitus.

关 键 词：心血管疾病 白蛋白尿 患病率 尿白蛋白肌酐比 

分 类 号：R181.3[医药卫生—流行病学] R696.2[医药卫生—公共卫生与预防医学] R54