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Bhatt VR, Khese VB, Jadhav SL, Kakrani AL. Urinary Albumin Excretion, Estimated Glomerular Filtration Rate, and Prevalence of Microalbuminuria in Obese Nondiabetic and Nonhypertensive Adults: A Cross-Sectional Study. Indian J Nephrol 2019; 29:166-171. [PMID: 31142962 PMCID: PMC6521762 DOI: 10.4103/ijn.ijn_116_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Context: Obesity even in absence of diabetes and hypertension increases the risk for microalbuminuria (MAU), glomerular hyperfiltration, and therefore nephropathy. Aims: This study aims to assess the urinary albumin excretion (UAE), prevalence of MAU, and values of estimated glomerular filtration rate (eGFR) in obese nondiabetic and nonhypertensive patients, vis a vis thin healthy subjects, and attempts to correlate anthropometric measurements with UAE and eGFR. Setting and Design: Cross-sectional analytical study on 60 cases who were obese according to Asia Pacific guidelines and 60 nonobese controls. Patients with diabetes, hypertension, ischemic heart disease, and established renal disease were excluded. Methods and Material: Albuminuria was assessed in each patient by quantitative immunoturbidimetry method on a spot urine sample. eGFR was calculated by Cockcroft–Gault formula. Statistical Analysis: Data was analyzed using SPSS (2015 version). Mann–Whitney U-test, Fisher Exact test, and Spearman's correlation coefficient was used for various variables. Results: The mean age of cases was 31.90 ± 6.32 years. About 78.33% were in class 1 and 21.66% in class 2 obese groups. The mean UAE at 21.20 ± 26.82 mg/g creatinine was higher in the case group. The prevalence of MAU was 11.66% and 3.33% in case and control groups, respectively. The cases had a significantly higher mean eGFR of 123.29 ± 20.49 mL/min/kg as compared with controls who had a mean eGFR of 106.59 ± 10.15 mL/min/kg. There was moderate correlation between anthropometric measurements and eGFR. Conclusion: Younger, class 1 obese patients had a higher UAE, eGFR, and three times higher MAU prevalence, even in absence of diabetes and hypertension, with a correlation between anthropometry and eGFR as compared with nonobese individuals.
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Affiliation(s)
- V R Bhatt
- Department of Medicine, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India
| | - V B Khese
- Department of Medicine, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India
| | - S L Jadhav
- Department of Community Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India
| | - A L Kakrani
- Department of Medicine, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India
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Lee SH, Kim DH, Kim YH, Roh YK, Ju SY, Nam HY, Nam GE, Choi JS, Lee JE, Sang JE, Han K, Park YG. Relationship Between Dyslipidemia and Albuminuria in Hypertensive Adults: A Nationwide Population-Based Study. Medicine (Baltimore) 2016; 95:e3224. [PMID: 27100412 PMCID: PMC4845816 DOI: 10.1097/md.0000000000003224] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
This study aimed to estimate the relationship between various lipid abnormalities and albuminuria in hypertensive Korean adults. Data obtained from the Korea National Health and Nutrition Examination Survey in 2011 to 2012 were analyzed. The study included 2330 hypertensive participants. Total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) levels were measured. Dyslipidemia parameters were defined as high TG ≥200 mg/dL, low HDL-C as HDL-C <40 mg/dL, high TC/HDL-C as TC/HDL-C ratio ≥4, high TG/HDL-C as TG/HDL-C ratio ≥3.8, and high LDL-C/HDL-C as LDL-C/HDL-C ratio ≥2.5. Albuminuria was defined as a urine albumin to creatinine ratio (ACR) ≥30 mg/g. Women with albuminuria showed significantly higher levels of TG, TC/HDL-C, and TG/HDL-C and a lower level of HDL-C than women without albuminuria (all P < 0.05). LogTG, TC/HDL-C, and logTG/HDL-C were positively correlated with ACR in both men and women; however, HDL-C was negatively correlated with ACR in women and non-HDL-C was positively correlated with ACR in men. In men, there was no association between ACR and lipid parameters. However, in women, higher values for logTG, TC/HDL-C, and logTG/HDL-C were associated with an increased odds ratio (OR) for albuminuria (OR [95% confidence interval]: 1.53 [1.06-2.21], 1.21 [1.02-1.45], and 1.78 [1.21-2.63], respectively) and HDL-C with a decreased OR for albuminuria (0.78 [0.67-0.92]) after adjusting for all covariates. LogTG, TC/HDL-C, and logTG/HDL-C were associated with an increased prevalence of albuminuria in hypertensive women. Screening and treatment for dyslipidemia may be necessary for hypertensive women to address potential albuminuria.
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Affiliation(s)
- Sung-Ho Lee
- From the Department of Family Medicine, Korea University, College of Medicine, Seoul (S-HL, DHK, Y-HK, H-YN, G-EN, J-SC, J-EL, J-ES); Department of Family Medicine, Hallym University, College of Medicine, Chunchon (YKR); Department of Family Medicine, Catholic University (SYJ); and Department of Biostatistics, The Catholic University of Korea, College of Medicine, Seoul (KDH, Y-GP), Republic of Korea
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Hasanato RM. Diagnostic efficacy of random albumin creatinine ratio for detection of micro and macro-albuminuria in type 2 diabetes mellitus. Saudi Med J 2016; 37:268-73. [PMID: 26905348 PMCID: PMC4800890 DOI: 10.15537/smj.2016.3.13567] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2015] [Accepted: 12/29/2015] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVES To compare a less cumbersome random albumin creatinine ratio (RACR) with 24-hour urinary albumin excretion (UAE) for detection of renal damage in patients with type 2 diabetes mellitus (T2DM). METHODS This retrospective study performed between March 2013 and June 2014 at the Department of Pathology, King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia included 122 patients (mean age 54 ± 15, 104 females and 18 males) with T2DM. Urine albumin levels of less than 30 mg/g was considered normal, from 30-300 mg/g considered as micro-albuminuria, and over 300 mg/g considered as macro-albuminuria. RESULTS Concordance between the 2 assays was observed in 114 (93.4%) samples. The sensitivity of RACR assay was 100%, specificity was 91.3% with a positive predictive value (PPV) of 95%, and a negative predictive value (NPV) of 100% in micro-albuminuria range. For macro-albuminuria, RACR had a sensitivity of 100%, specificity of 94.1% with PPV of 94% and NPV of 100%. Receiver operating characteristic (ROC) curves analysis cut-off values of 40 mg/g-300 mg/g for micro- and greater than 300 mg/g for macro-albuminuria revealed 100% sensitivity, 97.5% specificity, 95% PPV, and 100% NPV for micro-albuminuria, and 100% sensitivity, 94% specificity, 76% PPV, and 100% NPP for macro-albuminuria. The area under the curve for micro-albuminuria was 100% and 98.2% for macro-albuminuria. CONCLUSION Performance of RACR was comparable to 24 hour UAE assay particularly in excluding renal damage in T2DM.
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Affiliation(s)
- Rana M Hasanato
- Department of Pathology, College of Medicine and University Hospitals, King Saud University, Riyadh, Kingdom of Saudi Arabia. E-mail.
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Fowler SPG, Williams K, Hazuda HP. Diet soda intake is associated with long-term increases in waist circumference in a biethnic cohort of older adults: the San Antonio Longitudinal Study of Aging. J Am Geriatr Soc 2015; 63:708-15. [PMID: 25780952 DOI: 10.1111/jgs.13376] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVES To examine the relationship between diet soda (DS) intake (DSI) and long-term waist circumference (WC) change (ΔWC) in the biethnic San Antonio Longitudinal Study of Aging (SALSA). DESIGN Prospective cohort study. SETTING San Antonio, Texas, neighborhoods. PARTICIPANTS SALSA examined 749 Mexican-American and European-American individuals aged 65 and older at baseline (baseline, 1992-96); 474 (79.1%) survivors completed follow-up 1 (FU1, 2000-01), 413 (73.4%) completed FU2 (2001-03), and 375 (71.0%) completed FU3 (2003-04). Participants completed a mean of 2.64 follow-up intervals, for 9.4 total follow-up years. MEASUREMENTS DSI, WC, height, and weight were measured at outset and at the conclusion of each interval: baseline, FU1, FU2, and FU3. RESULTS Adjusted for initial WC, demographic characteristics, physical activity, diabetes mellitus, and smoking, mean interval ΔWC of DS users (2.11 cm, 95% confidence interval (CI) = 1.45-2.76 cm) was almost triple that of nonusers (0.77 cm, 95% CI = 0.29-1.23 cm) (P < .001). Adjusted interval ΔWCs were 0.77 cm (95% CI = 0.29-1.23 cm) for nonusers, 1.76 cm (95% CI = 0.96-2.57 cm) for occasional users, and 3.04 cm (95% CI = 1.82-4.26 cm) for daily users (P = .002 for trend). This translates to ΔWCs of 0.80 inches for nonusers, 1.83 inches for occasional users, and 3.16 for daily users over the total SALSA follow-up. In subanalyses stratified for selected covariates, ΔWC point estimates were consistently higher in DS users. CONCLUSION In a striking dose-response relationship, increasing DSI was associated with escalating abdominal obesity, a potential pathway for cardiometabolic risk in this aging population.
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Affiliation(s)
- Sharon P G Fowler
- Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas
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Shah RV, Allison MA, Lima JAC, Abbasi SA, Mongraw-Chaffin M, Jerosch-Herold M, Ding J, Budoff MJ, Murthy VL. Liver steatosis and the risk of albuminuria: the multi-ethnic study of atherosclerosis. J Nephrol 2015; 28:577-84. [PMID: 25712234 DOI: 10.1007/s40620-015-0177-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Accepted: 01/30/2015] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To measure association between hepatic fat and albuminuria (an early marker of renal injury) in individuals without diabetes or hypertension. METHODS 2,281 individuals in the Multi-Ethnic Study of Atherosclerosis without diabetes or hypertension, renal disease, or excess alcohol consumption underwent computed tomography (CT) for assessment of liver attenuation (marker of hepatic lipid content) and urinalysis (for albuminuria) at initial study visit, with assessment of incident and prevalent albuminuria by logistic regression in follow-up. RESULTS After adjustment for age, gender, race, smoking, blood pressure, insulin resistance, and body mass index, individuals with less liver fat (higher liver CT attenuation) had a lower probability of having albuminuria at Exam 1 (OR per 10 unit increase in attenuation 0.77, 95 % CI 0.61-0.97, P = 0.02). At median 9.3 years follow-up, albuminuria was identified in 129 individuals were (5.8 %). In fully adjusted models (with age, smoking, body mass index, blood pressure, diabetes and hypertension as time-dependent covariates), lower liver attenuation (greater liver fat) was associated with higher risk of incident albuminuria (OR 0.79, 95 % CI 0.66-0.94, P = 0.008). CONCLUSIONS Hepatic attenuation is associated with prevalent and incident albuminuria, an early, potent risk factor for renal risk in a population not clearly at risk for future renal failure.
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Affiliation(s)
- Ravi V Shah
- Department of Cardiology and Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 185 Pilgrim Road, Suite 454-East, Boston, MA, 02215, USA.
| | - Matthew A Allison
- Department of Family and Preventative Medicine, University of California-San Diego, San Diego, CA, USA
| | - Joao A C Lima
- Cardiology Division, Johns Hopkins Medical Institute, Baltimore, MD, USA
| | - Siddique A Abbasi
- Department of Cardiology and Medicine, Brown University, Providence, RI, USA
| | - Morgana Mongraw-Chaffin
- Department of Family and Preventative Medicine, University of California-San Diego, San Diego, CA, USA
| | | | - Jingzhong Ding
- Department of Medicine, Wake Forest Baptist Medical Center, Winston-Salem, NC, USA
| | - Matthew J Budoff
- Department of Cardiology and Medicine, University of California-Los Angeles, Los Angeles, CA, USA
| | - Venkatesh L Murthy
- Cardiovascular Medicine Division, Department of Medicine, Nuclear Medicine and Cardiothoracic Imaging Divisions, Department of Radiology, University of Michigan, 1338 Cardiovascular Center, Ann Arbor, MI, USA.
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Yoon SJ, Kim DH, Nam GE, Yoon YJ, Han KD, Jung DW, Park SW, Kim YE, Lee SH, Lee SS, Kim YH. Prevalence and control of hypertension and albuminuria in South Korea: focus on obesity and abdominal obesity in the Korean National Health and Nutrition Examination Survey, 2011-2012. PLoS One 2014; 9:e111179. [PMID: 25360593 PMCID: PMC4215993 DOI: 10.1371/journal.pone.0111179] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Accepted: 09/24/2014] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Albuminuria is associated with cardiovascular disease, and the relationship between albuminuria and hypertension is well established in many studies. So the control of hypertension is critical for decreasing cardiovascular events and albuminuria. Obesity and abdominal obesity are also associated with hypertension and albuminuria. Therefore, we analyzed the relationship between albuminuria and the prevalence and control of hypertension in the general Korean population according to obesity status. METHODS We analyzed data from the 2011-2012 Korea National Health and Nutrition Examination Survey, and 9,519 subjects were included. Subjects were divided into four groups: non-obese/normal waist circumference, non-obese/high waist circumference, obese/normal waist circumference, and obese/high waist circumference. RESULTS Systolic blood pressure and diastolic blood pressure were positively associated with albumin-creatinine ratio in all groups (all p values <0.005). Non-obese/normal waist circumference group were more likely to have hypertension (odds ratios [95% confidential intervals (CIs)] were 3.20 [2.21-4.63] in microalbuminuria level and 3.09 [1.05-9.14] in macroalbuminuria level), and less likely to have controlled hypertension (odds ratios <1 for both albuminuria levels) after adjusting for all covariates. Obese/normal waist circumference group were also more likely to have hypertension (odds ratio [95% CI] were 3.10 [1.56-6.15] in microalbuminuria level and 21.75 [3.66-129.04] in macroalbuminuria level), and less likely to have controlled hypertension in macroalbuminuria level (odds ratio [95% CI], 0.04 [0.01-0.15]). CONCLUSIONS Non-obese and normal waist circumference subjects have an increased prevalence and decreased control of hypertension in microalbuminuria and macroalbuminuria levels. Screening for albuminuria may provide helpful information about hypertension and blood pressure control, particularly in the non-obese and normal waist circumference subjects.
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Affiliation(s)
- Su-Jung Yoon
- Department of Family Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Do-Hoon Kim
- Department of Family Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Ga-Eun Nam
- Department of Family Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Yeo-Joon Yoon
- Department of Family Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Kyung-Do Han
- Department of Medical Statistics, Catholic University College of Medicine, Seoul, South Korea
| | - Dong-Wook Jung
- Department of Family Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Sang-Woon Park
- Department of Family Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Young-Eun Kim
- Department of Family Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Sung-Ho Lee
- Department of Family Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Sang-Su Lee
- Department of Family Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Yang-Hyun Kim
- Department of Family Medicine, Korea University College of Medicine, Seoul, South Korea
- * E-mail:
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