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Objective To investigate the distribution of the prevalence of albuminuria in elderly population of a community in Tianjin and analyze the situation of their early renal injury and its clinical and environmental risk factors.Methods The morning spot urine sample and the clinical data from 2 050 old population (aged ≥ 60 years)who took part in healthy examination were collected.The concentration of urine albumin and creatinine were tested,and the albumin/creatinine ratio(ACR)was calculated.We analyzed the prevalence of albuminuria,and used logistic regression to analyze the odd ratio(OR) of risk factors.Results In the 2 050 participants,the prevalence was 1162 cases (56.69％) for hypertension,264 cases (12.86％) for diabetes and 568 cases (27.71％) for albuminuria.The prevalence of ACR ＞ 30 mg/g was lower in men than in women (21.61％ vs.32.55％,P＜0.001).The OR for increased ACR was 1.45 in 70-79y subjects as compared with 60-69y subjects,and the OR was 1.89 in ＞80y old people.The OR of increased ACR was 2.03 in ＞80y old people after adjusting gender.Body mass index and waist circumference were not the risk factors of increased ACR after adjusting confounding factors.There was an association between the prevalence of albuminuria and triglycerides(OR=1.19),hypertension(OR=1.68),diabetes(OR=1.95).ACR value was increased along with increased number of cigarettes,however,there was also no association between smoking and albuminuria(P＞ 0.05).Physical activity could reduce the risk of albuminuria,the OR of ACR＞30 mg/g in those undertaking a activity once daily was 0.52 (P =0.027) Conclusions There is a high prevalence of albuminuria in elderly population(higher in female than in male) in a community of Tianjin.Hypertension and diabetes have the greatest influence on ACR.Additionally,the physical activity once daily can reduce the risk of albuminuria.
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Objective To explore the association between acute ischemic stroke and albumin to creatinine ratio (ACR).Methods A case-control study.During January to December in 2013, 127 acute ischemic stroke patients as case group and 150 controls who were similar with case group in age and gender were recruited in Tianjin Union Medicine Center . According to diabetes , hypertension , cardiovascular diseases and patients without these three diseases , case group was divided into A1, B1, C1 and D1 subgroups, control group was divided into A2, B2, C2 and D2 subgroups in the same way.The first morning urine from participants were collected .Urinary albumin concentration was tested by nephelometry , urinary creatinine was examined by using enzymic method , ACR were calculated(≥30 mg/g as the cutoff value). Then difference of ACR between case and control group was compared , the cutoff value of albuminuria for ischemic stroke patients was analyzed by ROC , and the risk factor of ischemic stroke were analyzed by logistic regression analysis.Results The prevalence of albuminuria in ischemic stroke patients was 38.58%(49).According to analysis of covariance, after adjustment for age, gender, cardiac-disease, diabetes, hypertension, lnACR in case group was significantly higher than control group (3.18 mg/g vs 2.78 mg/g, t=2.13 P=0.03), especially D1 was significantly higher than D2 subgroup (3.01 mg/g vs 2.51 mg/g,t=5.56,P=0.009) .If 19.82 mg/g from ROC analysis was used as the cut-off value, the sensitivity and specificity are 68.5% and 61.7%.The odds ratio ( OR ) of ACR >19.82 mg/g was about 2-fold when compared with ACR<19.82 mg/g adjusted for stroke risk factors , and the OR value is 2.43 in comparison of patients without diabetes , hypertension and cardiovascular diseases .Conclusions Urinary albumin excretion is the independent risk factor of ischemic stroke .The increased urinary albumin has important clinical significance to predict the risk of ischemic stroke for the patients without diabetes , hypertension and cardiovascular diseases.
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Objective To investigate the situation of urine albumin measurement of clinical laboratory in Tianjin.Methods Control materials from patient mixed urine samples were made to validate precision in the clinical laboratories in Tianjin.Reference Material ERM-DA470K was prepared as the first external quality assessment ( EQA) sample, and the bias between laboratories was calculated.Then we give some advice about the methods of routine maintenance, calibration, standardized operation, internal quality assessment and so on to the laboratories which were not qualified in the first EQA.Then the second EQA was carried out and CV and bias were culculated.Results 52 clinical laboratories has 12 series of instruments and 17 series of reagents.The precision research showed that most laboratories ( 93.55%) had good precision for urine albumin measurement, while CV of inter-laboratory was great:the range of low level of control sample was 8.91 -43.95 mg/L, 34.46% for CV; and the high level was 36.32 -281 mg/L, 28.51% for CV.Only 36.5% laboratories were qualified in the first EQA. The qualified rate for nephelometry and turbidimetry was higher (55.6%, 42.9%).The qualified rate of trueness verification was 58.6%in the second EQA, and the CV between laboratories was significantly decreased, Inter-laboratory CV of the five samples were:19.83%, 13.57%, 13.41%, 13.08%, 11.37%. The qudified rate for nephelomety and turbidimetry was 71.4% and 56.3%.Conclusions There are a mide variety of measurement systems of urine albumin in Tianjin, and the CV between these systems is great.Clinical laboratory should strengthen the laboratory standardization operation and upgrade calibration testing to improve the testing consistency.