Cross-sectional associations between reproductive lifespan duration and urinary albumin-creatinine ratio / 中华内科杂志

Objective:To investigate the association between reproductive lifespan duration (RLD) and urinary albumin-creatinine ratio (UACR) in a Chinese postmenopausal population.Methods:This cross-sectional study included 11 055 naturally postmenopausal women from seven regions of China from May to December 2011. RLD was divided into four groups. Propensity score matching was performed to reduce bias, and logistic regressions and stratifications were conducted to investigate the association between RLD and increased UACR (≥30 mg/g). Mediation effect analysis was performed to quantify the effect of RLD on cardiovascular disease (CVD) induced by elevated UACR.Results:There were 2 373 participants with a RLD of 18-31 years, 2 888 participants with a RLD of 32-34 years, 2 472 participants with a RLD of 35-36 years, and 3 322 participants with a RLD of 37-50 years. The shortest RLD (18-31 years) group was characterized with older age ( P<0.001), a higher incidence of CVD ( P=0.025), and the highest level of UACR ( P<0.001). After adjusting for confounders, women with a longer RLD (37-50 years group) exhibited a lower risk of UACR elevation compared with those with the shortest RLD (18-31 years group) ( OR=0.72, 95% CI 0.64-0.82, P<0.001). Every 1-year extension in RLD was linked to a 2% reduction in the risk of UACR elevation ( OR=0.98, 95% CI 0.97-0.99, P<0.001). Stratified analysis revealed a more significant association between RLD and UACR in women who were a normal weight ( P=0.003) or overweight ( P=0.001), in those without CVD history ( P=0.001), and in those with impaired estimated glomerular filtration rate ( P=0.004). The mediation casual analysis showed that 3.0% of proteinuria inducing CVD events was mediated by RLD ( P=0.048). Conclusion:A longer RLD (37-50 years) is associated with a lower UACR in Chinese postmenopausal women.

Prevalence of albuminuria and its association with cardiovascular diseases in Chinese residents aged over 35 years / 中华内科杂志

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 34 647 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 xˉ±s, and t-tests were used for comparisons between indicators. Qualitative data were expressed as rate or constituent ratio, and the χ2 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.

Association between residual cholesterol and the risk of subclinical renal damage / 西安交通大学学报(医学版)

【Objective】 Dyslipidemia has shown to be associated with cardiovascular, metabolic and renal diseases. This study aimed to investigate the association between residual cholesterol and the risk of subclinical renal damage (SRD). 【Methods】 A total of 2 342 participants were recruited from the previously established Hanzhong Adolescent Hypertension Study cohort. According to estimated glomerular filtration rate(eGFR) and urinary albumin-to-creatine ratio(uACR), the subjects were divided into SRD group and non-SRD group. The associations of residual cholesterol with eGFR, uACR, and the risk of SRD were analyzed by multiple linear and Logistic regression analyses. 【Results】 Residual cholesterol was positively correlated with uACR(r=0.081, P<0.001) but negatively correlated with eGFR (r=-0.091, P<0.001). Multiple linear regression analysis revealed that residual cholesterol was an influencing factor of uACR (β=0.075, P<0.001) and eGFR (β=-0.027, P<0.001) after adjustment for gender, age, smoke, alcohol, exercise, BMI, hypertension, diabetes and serum uric acid. In addition, Logistic regression analysis revealed that residual cholesterol was significantly associated with the risk of SRD independently of potential confounders [OR(95% CI)=1.387 (1.113-1.728), P<0.001]. Further subgroup analysis showed that residual cholesterol was significantly associated with the risk of SRD in women but not in men. 【Conclusion】 Residual cholesterol is a contributing factor in the risk of subclinical renal damage with gender-specific association.

Correlation between serum concentration of angiogenic suppressor protein 1 and urinary albumin creatinine ratio in patients with type 2 diabetes mellitus and diabetic nephropathy / 中国综合临床

Objective:To investigate the correlation between serum concentration of vasohibin-1 (VASH-1) and urinary albumin creatinine ratio (UACR) in patients with type 2 diabetes mellitus (T2DM) and diabetic nephropathy.Methods:The clinical data of 196 patients with T2DM from February 2017 to December 2020 were analyzed retrospectively. According to whether diabetic nephropathy (DN) was combined, 33 patients without DN of T2DM were divided into the control group,and 163 patients with DN of T2DM were divided into the case group, and the case group was divided into four groups:normal albuminuria group (groupⅠ, UACR <30 mg/g, 21 cases),microalbuminuria group (groupⅡ, UACR ≥30-≤300 mg/g, 50 cases), clinical albuminuria group (group Ⅲ, UACR>300 mg/g, 43 cases), and clinical albuminuria hypertensive group (groupⅣ, UACR >300 mg/g with hypertension, 49 cases). Serum levels of VASH-1,C-reactive protein(CRP), erythrocyte sedimentation rate (ESR) and transforming growth factor β1 (TGF-β1) with other biochemical indicators were measured. T-test was used for comparison between measurement data groups in accordance with normal distribution, one-way ANOVA was used for comparison between multiple groups, q-test was used for pairwise comparison, and χ2 test was used for comparison between counting data groups. The influencing factors were analyzed by multivariate Logistic regression.Pearson correlation analysis was used to analyze the correlation between vash-1 and UACR. Results:UACR((1 175.9±120.4) mg/g), CRP((9.80±2.01) mg/L), ESR((20.61±2.20) mm/h),TGF-β1((16.75±2.05) μg/L), VASH-1((645.3±183.5) ng/L) in case group were higher than that in the control group((11.5±2.0) mg/g, (4.77±1.34) mg/L, (8.33±1.56) mm/h, (10.63±1.97) μg/L, (416.3±162.1) ng/L), and there were significant differences between the two groups ( t=123.39,13.76,30.54,15.75,6.66; all P<0.001). Multivariate logistic regression analysis showed that VASH-1 ( OR=1.881,95% CI 1.146-3.089), UACR( OR=1.511,95% CI 1.064-2.146), TGF-β1( OR=1.846,95% CI 1.135-3.001)were all risk factors for DN of T2DM ( P values were 0.009, 0.022 and 0.012). Serum VASH-1 ((693.5±201.4), (709.8±214.7) ng/L] in group Ⅲ and group Ⅳ were higher than those in group Ⅰ and group Ⅱ ((585.3±162.1), (632.9±165.5) ng/L). There was significant difference between the two groups ( F=129.46, P<0.001). The CRP ((7.08±1.36), (8.99±3.72), (10.58±3.48), (11.64±3.50) mg/L), ESR ((17.36±1.76), (19.05±4.12), (21.45±5.74), (22.69±9.13) mm/h) and TGF- β1 ((14.75±1.97), (16.50±1.90), (17.06±1.23), (18.39±1.46) μg/L) of groupⅠ, groupⅡ, groupⅢ and groupⅣ increased gradually, and there were significant differences between the four groups ( F values were 73.48, 156.61, 25.83; all P<0.001). Pearson correlation analysis showed that there was a significant positive correlation between VASH-1 and UACR ( r=0.532, P=0.008). Conclusion:The concentration of VASH-1 in serum of patients with T2DM complicated with DN increased with the increase of UACR. VASH-1 may become a new marker for predicting early DN of T2DM.

Characterization of Diabetic Nephropathy and Its Correlates in a Selected Outdoor-Based Diabetic Clinic in Rangpur, Bangladesh

Introduction@#Diabetes mellitus (DM) is a global public health problem. DM is associated with the rising burden of diabetic complications. Diabetic nephropathy (DN) is one of the life-threatening and irreversible microvascular complications of DM.@*Methods@#A cross-sectional study was conducted from November 2017 to April 2018. This study aimed to characterize the proportion of DN among people living with diabetes (n=290, where 40 T1DM, 200 T2DM as cases group and 50 nondiabetic as a control group) and the factors associated with it. The sample was selected using convenience sampling. Data were collected using structured questionnaire and analyzed by SPSS-22. Stages of DN were classified according ‘Revised Classification of DN’ given by the ‘Joint Committee on Diabetic Nephropathy’, Japan, 2014.@*Results@#The proportion of pre-nephropathy (PN), incipient nephropathy (IN) and overt nephropathy (ON) was 10%, 82.5% and 7.5% respectively in T1DM. Similarly, in T2DM the proportion of PN, IN, ON and chronic kidney failure (CKF) was 5.5% 81%, 10%, and 3.5% respectively. Irrespective of diabetic group, according to multivariate analysis, older age (adjusted OR =1.05, CI: 1.01-1.08; adjusted OR: 2.33, CI: 2.01-2.99), and female sex (adjusted OR = 0.39, CI: 0.19-0.77) were independently associated with DN adjusting BMI, SBP, DBP and FBS level.@*Conclusions@#This study showed the proportion of DN was high among diabetic and mostly in type 2 diabetics with severe stage. Older age, and female sex were independently associated with DN.

VEGF-B antibody and interleukin-22 fusion protein ameliorates diabetic nephropathy through inhibiting lipid accumulation and inflammatory responses

Diabetic nephropathy (DN) is considered the primary causes of end-stage renal disease (ESRD) and is related to abnormal glycolipid metabolism, hemodynamic abnormalities, oxidative stress and chronic inflammation. Antagonism of vascular endothelial growth factor B (VEGF-B) could efficiently ameliorate DN by reducing renal lipotoxicity. However, this pharmacological strategy is far from satisfactory, as it ignores numerous pathogenic factors, including anomalous reactive oxygen species (ROS) generation and inflammatory responses. We found that the upregulation of VEGF-B and downregulation of interleukin-22 (IL-22) among DN patients were significantly associated with the progression of DN. Thus, we hypothesized that a combination of a VEGF-B antibody and IL-22 could protect against DN not only by regulating glycolipid metabolism but also by reducing the accumulation of inflammation and ROS. To meet these challenges, a novel anti-VEGFB/IL22 fusion protein was developed, and its therapeutic effects on DN were further studied. We found that the anti-VEGFB/IL22 fusion protein reduced renal lipid accumulation by inhibiting the expression of fatty acid transport proteins and ameliorated inflammatory responses

Correlation between markers of early renal injury in urine and serum homocysteine elevation / 中华健康管理学杂志

Objective:To investigate the correlation between early renal impairment markers in urine and elevated serum homocysteine.Methods:Clinical data of serum homocysteine (Hcy) and early renal injury markers in urine of the health examination population from the Physical Examination Center of Peking University Third Hospital from January 2019 to May 2020 were retrospectively analyzed (1133 cases). The previous medical history, age, sex, blood pressure, body mass index (BMI) of the subjects were collected. Early urine kidney injury markers, including urine microalbumin (U-mALB), urinary N-acetyl-β-D-glucosaminidase (NAG), urinary albumin to creatinine ratio (UACR), and serum renal function, liver function, blood lipid, myocardial enzyme and glycosylated hemoglobin (HbA 1C), etc. were also collected. Those with incomplete previous history, general information, biochemical indexes and decreased estimated glomerular filtration rate (eGFR) were excluded, and 969 cases were included. The included subjects were divided into the normal group (?15 μmol/L) and the elevated group (≥15 μmol/L) according to Hcy levels, the indexes with significant difference between the two groups were included as independent variables, and the multivariate logistic regression was used to explore the influence factors of Hcy elevation. Results:The male ratio, the incidence of increased U-mALB, NAG and UACR were significantly higher in the elevated group than those in the normal Hcy group (93.4% vs 50.6%, 16.4% vs 8.0%, 23.0% vs 14.0%, 13.9% vs 7.9%) (all P<0.05). Systolic blood pressure, diastolic blood pressure, serum uric acid, calcium, alanine aminotransferase (ALT) and lactate dehydrogenase in the elevated group were higher than those in the normal group [(127.5±15.4) vs (121.9±16.2) mmHg (1 mmHg=0.133 kPa), (78.6±9.3) vs (76.0±11.0) mmHg, (385.9±86.0) vs (335.7±88.2) μmol/L, (2.392±0.086) vs (2.366±0.092) mmol/L, (27.8±21.0) vs (23.8±20.2) U/L, (198.3±28.4) vs (192.2±31.2) U/L] (all P<0.05), while high density lipoprotein cholesterol (HDL-C), serum phosphorus were lower than those in the normal group [(1.21±0.25) vs (1.31±0.30) mmol/L, (1.107±0.154) vs (1.158±0.159) mmol/L] (all P<0.05). The increased systolic blood pressure, male, uric acid, U-mALB, NAG were independent correlative factors of Hcy elevation. Conclusion:The increase of Hcy is independently correlated with urine U-mALB and NAG, which suggests that the level of Hcy should be detected as soon as possible in patients with elevated early renal injury markers.

Performance Evaluation of MEDITAPE UC-11A Strip Test in Estimating the Urine Albumin-to-Creatinine Ratio and Urine Protein-to-Creatinine Ratio

30 mg/g), the concordance rate, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of UACR, analyzed using MEDITAPE UC-11A, were 80.5, 97.5, 67.0, 70.3, and 97.1%, respectively. Using UPCR, analyzed via quantitative assay, as a reference to estimate proteinuria (UPCR >0.15 g/g), the concordance rate, sensitivity, specificity, PPV, and NPV of UPCR, analyzed using MEDITAPE UC-11A, were 86.7, 94.4, 81.5, 77.6, and 95.6%, respectively.CONCLUSIONS: UACR and UPCR, analyzed using MEDITAPE UC-11A, exhibited relatively high sensitivity and NPV, which is beneficial for laboratory screening for both albuminuria and proteinuria.

A study to find the correlation between 24-hour urinary protein and spot urinary albumin to creatinine ratio and to determine the accuracy of spot urinary albumin to creatinine ratio as an indicator to detect proteinuria and its use as a rapid alternative test over 24-hour urinary protein in preeclamptic women

Background: Preeclampsia is a multisystem endothelial disease leading to glomeruloendotheliosis with endothelial leak causing significant proteinuria. It is associated with high maternal and fetal risks and fetomaternal morbidity and mortality. Spot urinary albumin to creatinine ratio (ACR) leads to earlier detection of glomerular damage leading to prompt management of preeclamptic patients. To determine the accuracy of Spot Urinary ACR as an indicator to detect proteinuria and its use as a rapid alternative test over 24-hour urinary protein in women with Preeclampsia and to find the correlation between the two.Methods: Spot urinary ACR was measured in 70 consecutive patients with preeclampsia in Assam Medical College, Dibrugarh. The best cut-off value to differentiate between significant and insignificant proteinuria was calculated. The mean, standard deviation and range of various parameters were computed and various statistical tests were used. The Area under the curve and ROC curve were plotted.Results: The best cut-off value to differentiate significant and insignificant proteinuria was calculated as 291.9 mg/g beyond which adverse fetomaternal outcomes and complications were seen. The correlation coefficient between 24-hour urinary protein and spot urinary albumin to creatinine ratio was 0.922 highly significant. The area under the curve was found to be 0.98 with a standard error of 0.0155 which implied that the discriminant ability of spot urinary ACR to differentiate significant proteinuria from insignificant proteinuria in patients with preeclampsia was found to be 98%. Similar studies mentioned in the table below showed a good correlation between 24-hour urinary protein estimation and spot urinary ACR.Conclusions: Compared with 24-hour urinary protein excretion, spot urinary ACR is a simple and accurate indicator of significant proteinuria and helps to detect fetomaternal outcomes in preeclamptic women which may lead to prompt management to reduce fetomaternal complications.

Consistency Analysis of Urine Albumin Results by Urinary Dry Chemical Analysis,Scatter Turbidimetry,Enzymatic Assays and Urine Creatinine and Albumin-to-Creatinine Ratio / 现代检验医学杂志

Objective To analysis of consistency of results in evaluating urine dry chemical method and nephelometry in the detection of urine albumin(UAlb) and urine dry chemical method and enzymatic method in the detection of urinary creatinine (Cr) and albumin-to-creatinine ratio(ACR).Methods In 157 urine samples collected firstly in the morning,urine microalbumin was determined by the urine dry chemistry method and nephelometry,and urine creatinine was determined by the urine dry chemistry method and the enzyme method respectively.The kappa was applied to evaluating the consistency.Results The results of UAlb showed that the kappa was 0.837 9 (95％CI:0.718 1～0.957 7),the results of urine creatinine showed that the kappa was 0.769 7 (95％CI:0.665 2～0.874 2),and the results of albumin-to creatinine ratio showed that the kappa was 0.756 6 (95％CI:0.628 6～0.884 6).Conclusion The results of urine Alb,urinary creatininc and ACR by urine dry chemistry method and urine albumin by nephelometry,and urine Cr by enzymatic method and ACR had high consistency.Urine dry chemical method can be used for screening of early renal disease and for screening in CKD grading,screening for early screening or for long-term maintenance.

Comparison of Urine Albumin-to-Creatinine Ratio (ACR) Between ACR Strip Test and Quantitative Test in Prediabetes and Diabetes

BACKGROUND: Albuminuria is generally known as a sensitive marker of renal and cardiovascular dysfunction. It can be used to help predict the occurrence of nephropathy and cardiovascular disorders in diabetes. Individuals with prediabetes have a tendency to develop macrovascular and microvascular pathology, resulting in an increased risk of retinopathy, cardiovascular diseases, and chronic renal diseases. We evaluated the clinical value of a strip test for measuring the urinary albumin-to-creatinine ratio (ACR) in prediabetes and diabetes. METHODS: Spot urine samples were obtained from 226 prediabetic and 275 diabetic subjects during regular health checkups. Urinary ACR was measured by using strip and laboratory quantitative tests. RESULTS: The positive rates of albuminuria measured by using the ACR strip test were 15.5% (microalbuminuria, 14.6%; macroalbuminuria, 0.9%) and 30.5% (microalbuminuria, 25.1%; macroalbuminuria, 5.5%) in prediabetes and diabetes, respectively. In the prediabetic population, the sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy of the ACR strip method were 92.0%, 94.0%, 65.7%, 99.0%, and 93.8%, respectively; the corresponding values in the diabetic population were 80.0%, 91.6%, 81.0%, 91.1%, and 88.0%, respectively. The median [interquartile range] ACR values in the strip tests for measurement ranges of 300 mg/g were 9.4 [6.3-15.4], 46.9 [26.5-87.7], and 368.8 [296.2-575.2] mg/g, respectively, using the laboratory method. CONCLUSIONS: The ACR strip test showed high sensitivity, specificity, and negative predictive value, suggesting that the test can be used to screen for albuminuria in cases of prediabetes and diabetes.

Analysis of test results for determining urine albumin-to-creatinine ratio among health examination population in a hospital / 中华健康管理学杂志

Objective To investigate the prevalence of high urine albumin-to-creatinine ratio (ACR) among health check up population and evaluate the potential predictors for ACR. Methods A cross-sectional study was conducted among health check up population in the Zhongshan Hospital during 2015. Potential participants completed urine ACR test,body mass index (BMI) and blood test. ACR level was divided into two groups according to the K/DOQI recommendation:ACR Group(male:ACR≥17 mg/g;female:≥25 mg/g), Normal Group (male:ACR<17 mg/g;female:ACR<25 mg/g). Univariate and multivariate logistic regression models were performed to evaluate the associations of ACR with potential predictors (including age,sex,over-weight or obesity,hypertension,glucose metabolism disorders, hypertriglyceridemia,hypercholesterolemia,high low HDL-C and hyperuricemia). Result Totally 670 people from the health check up population were screened for ACR test, 54 cases were positive, the prevalence was 8.1％. Age, BMI, waist-to-height ratio, SBP, DBP, blood sugar and uric acid had statistical significance between Normal group and ACR group[Age 47.62 ± 11.29 vs. 53.83 ± 11.93, t=-3.858, P<0.01;BMI (24.05±3.12) kg/m2 vs. (24.94±3.49) kg/m2, t=-1.982, P<0.05;waist-to-height ratio 0.51±0.52 vs. 0.53 ± 0.06, Z=-2.146, P<0.05; SBP (mmHg, 1 mmHg=0.133 kPa) 115.31 ± 15.59 vs. 130.91 ± 23.66, t=-4.755, P<0.01;DBP(mmHg) 72.31 ± 9.16 vs. 80.02 ± 9.81, t=-5.897,P<0.01;blood sugar (mmol/L) 4.64 ± 1.20 vs. 5.57 ± 2.77, t=-2.466, P<0.01;uric acid (μmol/L) 362.99 ± 92.80 vs. 397.76 ± 95.62, t=-2.633, P<0.01]. Age, hypertension, glucose metabolism, HDL reduction were risk factors for urinary albumin/creatinine ratio. In the multivariate logistic regression model, hypertension status was found to be associated with ACR positive [odd ratio (OR): 2.843, 95％ confidence interval [CI, 1.472-5.493, P<0.01], glucose metabolism disorders (OR, 2.132, 95％CI, 1.042-4.365, P<0.05). As the number of risk factors increases, the rate of positive of ACR showed marked increase, comparing persons with no risk factors to those with four or more risk factors , the OR value rose up to 18.281. Conclusion Hypertension and glucose metabolism disorder are risk factors of chronic renal dysfunction. With the increase of risk factors, the rate of positive of ACR was higher. ACR test is recommended routine screening for people over the age of 50.

Association of peripheral and central systolic blood pressure with urinary albumin-to-creatinine ratio in a community-based population in Beijing / 中华预防医学杂志

Objective@#The aim of this study was to investigate the association of both peripheral and central systolic blood pressure (pSBP and cSBP) with urinary albumin-to-creatinine ratio (UACR) in a community-based population in Beijing.@*Methods@#A total of 3 479 Chinese subjects with questionnaire, UACR, pSBP, and cSBP data available were included from an atherosclerosis cohort of Peking University First Hospital in Shijingshan District, Beijing followed up from April to July in 2014. Multivariate linear regression analyses were used to examine the effect of pSBP and cSBP on lnUACR, and further tests for interactions were performed according to associated covariates.@*Results@#Subjects were (59.0±8.6) years old, 36.2% (n=1 260) were male, 46.0% (n=1 595) had hypertension, and 20.2% (n=700) had diabetes. The pSBP and cSBP was (126.9 ± 16.4) mmHg (1 mmHg=0.133 kPa), and (136.3 ± 16.7) mmHg, respectively. P50 (P25-P75) of UACR was 6.2 (4.2-11.1) mg/g. Both pSBP and cSBP were linearly associated with lnUACR adjusted for age, sex, body mass index, smoking status, drinking status, triglyceride, HDL-C, LDL-C, fasting glucose, creatinine, history of cardiovascular disease, antihypertensive and hypoglycemic agents (every 10 mmHg increase for pSBP: β=0.12, 95%CI: 0.10-0.15, P<0.001; for cSBP: β=0.11, 95%CI: 0.09-0.14, P< 0.001). The relationships were remained in subgroups such as non-hypertension group, non-diabetes group, normal UACR group, and 3-combination group (every 10 mmHg increase for pSBP: β=0.09, 95%CI: 0.05-0.13; β=0.12, 95%CI: 0.10-0.15; β=0.07, 95%CI: 0.06-0.09; β=0.08, 95%CI: 0.05-0.12. for cSBP: β=0.07, 95%CI: 0.04-0.11; β=0.11, 95%CI: 0.08-0.13; β=0.07, 95%CI: 0.05-0.08; β=0.06, 95%CI: 0.03-0.09, all P<0.001). Furthermore, analyses for interaction found that both pSBP and cSBP were more strongly associated with lnUACR in males, current smokers and subjects with high serum creatinine level (≥87 µmol/L) when compared with females, non-current smokers and subjects with low serum creatinine level (<87 µmol/L), respectively (all P for interaction<0.05).@*Conclusion@#The results showed that both pSBP and cSBP were independently associated with UACR in this Chinese community-based population even in low risk population suggesting well-controlled both peripheral and central blood pressure may reduce urinary albumin. Males, current smokers and subjects with higher serum creatinine should pay more attention to the impacts of pSBP and cSBP on UACR.

Ethnic disparity in inter-arm systolic blood pressure difference and its determinants among Asians with type 2 diabetes: A cross-sectional study / Journal of the ASEAN Federation of Endocrine Societies

@#<p><strong>OBJECTIVES:</strong> An inter-arm difference in systolic blood pressure (IADSBP) of 10 mmHg or more has been associated with cardiovascular disease (CVD) and increased mortality in T2DM patients. We aim to study ethnic disparity in IADSBP and its determinants in a multi-ethnic T2DM Asian cohort.<br /><strong>METHODOLOGY:</strong> Bilateral blood pressures were collected sequentially in Chinese (n=654), Malays (n=266) and Indians (n=313). IADSBP was analyzed as categories (<br /><strong>RESULTS:</strong> Malays (27.4%) and Indians (22.4%) had higher prevalence of IADSBP ?10 mmHg than Chinese (17.4%) (p=0.002). After adjustment for age, gender, duration of diabetes, hemoglobin A1c, body mass index (BMI), heart rate, pulse wave velocity (PWV), estimated glomerular filtration rate (eGFR), albumin-to-creatinine ratio (ACR), smoking, hypertension, soluble receptor for advanced glycation end products (sRAGE), and usage of hypertension medications, ethnicity remained associated with IADSBP. While Malays were more likely to have IADSBP ?10 mmHg than Chinese (OR=1.648, 95%CI: 1.138-2.400, p=0.009), Indians had comparable odds with the Chinese. BMI (OR=1.054, 95%CI: 1.022-1.087, p=0.001) and hypertension (OR=2.529, 95%CI: 1.811-3.533, p<0.001) were also associated with IADSBP ?10 mmHg.<br /><strong>CONCLUSION:</strong> IADSBP in Malays were more likely to be ?10 mmHg than the Chinese which may explain their higher risk for CVD and mortality. Measuring bilateral blood pressures may identify high-risk T2DM individuals for intensive risk factor-management.</p>

Analytical Evaluation of the DiaSys Albumin in Urine/CSF FS Kit for Urine Albumin Measurement Using a JEOL BioMajesty JCA-BM6010/C Analyzer

BACKGROUND: High albuminuria is defined as albumin excretion of >30 mg/24 hr or an albumin-to-creatinine ratio of 30 mg/g in a random urine sample. We assessed the analytical performance of the Albumin in Urine/CSF FS kit (DiaSys Inc., UK) using a BioMajesty JCA-6010/C analyzer (JEOL Inc., Japan). METHODS: Urine albumin concentrations were measured by the Albumin in Urine/CSF FS kit using a BioMajesty JCA-BM6010/C analyzer. Imprecision, linearity, and carry-over were measured according to the Clinical Laboratory and Standards Institute documents EP10 and EP9. The assay was compared with the ALB-T TQ Gen.2 (Roche, Germany) assay on a Cobas8000 C702 (Roche, Germany), the Tina-Quant Albumin (Roche, Switzerland) assay on a Hitachi7600-210 (Hitachi, Japan), and an Abbott urine albumin assay (Abbott Laboratories, USA) on a TBA 200FR (Toshiba, Japan) using 50 random urine samples. RESULTS: Within-run and total imprecision were 0.551-1.023% and 0.551-1.214%, respectively. Linearity ranged from 6.31 to 30.60 mg/dL, and functional sensitivity was 0.5 mg/dL. Results from the Albumin in Urine/CSF FS kit showed good correlation with the ALB-T TQ Gen.2 (r=0.987) and the Tina-Quant Albumin assays (r=0.991). However, the four assays categorized 18 of 50 urine samples into different albuminuria groups. CONCLUSIONS: Albumin in Urine/CSF FS testing on a BioMajesty JCA-BM6010/C analyzer showed good linearity, functional sensitivity, precision, and correlation with the ALB-T TQ Gen.2 and Tina-Quant Albumin assays. However, because some samples were categorized into different albuminuria groups by the different assays, further studies on the standardization of albuminuria assays are needed.

Relationship between urinary albumin-to-creatinine ratio and prehypertension among young migrant builders in Shanghai / 第二军医大学学报

Objective To explorethe relationship between urinary albumin-to-creatinine ratio (UACR) and blood pressure of young migrant builders in Shanghai. Methods A total of 3 195 builders (age ranged from 18 to 50) were selected from migrant builders of Shanghai Construction Group Co., Ltd. by using random clustersampling method. They were subjected to questionnaire interview, physical examination, and biochemical tests, including UACR, renal function, serum uric acid, serum lipid, and serum glucose. The participants were divided into 4 groups (I, II, III, and IV) according to the levels of UACR, and the ordinal multinomial logistic regression model was employed todetermine the relationship between UACR levels and blood pressure grouping (normal, pre-hypertension, and hypertension). Results Among the 3 195 builders, 3 112 (97. 4%) finished interview. The UACR (median [Q1-Q3]) levels and high-UACR ratio for the normal, pre-hypertension and hypertension groups were 0. 8 (0. 6-1. 2) mg/mmol, 0. 9 (0.7-1. 4) mg/mmol, and 1. 0 (0.8-1. 7) mg/mmol, and 6. 8%, 8. 0%, and 15. 6 %, respectively, with significant differences for both UACR levels and high-UARC ratios (P<0. 05) among the 3 blood pressure groups. According to the 25%, 50%, and 75% quartiles of UACR values, builders were classified into 4 groups. After adjustment of the other factors such as age, the average systolic pressures of the I, II, III, and IV UACR groups were (126. 8± 13. 3), (127. 9 ± 14. 2), (129.9 ± 14. 4), and(134. 2 ± 19. 0) mmHg (1 mmHg= 0. 133 kPa), and the average diastolic pressures of the 4 groups were (77. 6±9. 7), (78. 8±9. 2), (79. 2 ± 10. 4), and (81. 8 ± 12. 5) mmHg, respectively. UACR was positively correlated with both the average systolic pressures and diastolic pressures (P<0. 05). Logistic regression analysis showed that, after adjusting the factors such as age, body mass index, total cholesterol, and low density lipoprotein cholesterol, the odds ratio (OR) and 95% confidence interval (95% Cl) of pre-hypertension and/or hypertension, compared with I group, were 0. 98 (0. 80-1. 20), 1. 29 (1. 05-1. 58), and 1. 86 (1. 52-2. 28) for II, III, and IV groups, respectively. Conclusion The UACR is positively correlated with pre-hypertension and hypertension among young migrant builders in Shanghai.

Spot Urine Albumin to Creatinine Ratio and Serum Cystatin C are Effective for Detection of Diabetic Nephropathy in Childhood Diabetic Patients

Spot urinary albumin to creatinine ratio (ACR) measurement has been suggested as a surrogate to 24-hr urine collection for the assessment of microalbuminuria, and cystatin C (cysC) is known as an advantageous marker for renal function. The aim of this study was to evaluate the clinical values of spot urinary ACR and serum cysC for the assessment of diabetic nephropathy instead of 24-hr urine microalbumin in children and adolescents with diabetes. A total of 113 children and adolescents (age 12-19 yr, M:F = 47:66) with type 1 or 2 diabetes were enrolled. We evaluated the validity of spot urine ACR and serum cysC, and then compared them to 24-hr urine microalbumin and creatinine clearance. Spot urine ACR was correlated with 24-hr urine albumin excretion (R2 = 0.828, P = 0.001) and creatinine clearance (R2 = 0.249, P = 0.017). The ROC curve analysis of serum cysC demonstrated higher diagnostic accuracy than that of serum creatinine (AUC 0.732 vs 0.615). Both the measurements of spot urine ACR and serum cysC might better predict the presence of diabetic nephropathy than 24-hr urine microalbumin in childhood diabetic patients.

Association of serum 25-hydroxyvitamin D3 and urine albumin-to-creatinine ratio in type 2 diabetic patients / 中华内分泌代谢杂志

To study the association of serum 25-hydroxyvitamin D3 level with urine albumin-to-ereatinine ratio in 193 type 2 diabetic patients.Multivariate linear regression demonstrated that serum 25-hydroxyvitamin D3 level was an independent risk factor in predicting urine albumin excretion level in type 2 diabetic patients(β =-0.02,95％CI -0.04 - -0.01,P＜0.01 ).

Correlation of serum uric acid and early renal damage in patients with type 2 diabetes mellitus / 中华内分泌代谢杂志

The association of serum uric acid ( SUA ) and urine albumin-to-creatinine ratio ( ACR ) in patients with type 2 diabetes mellitus was explored. The ACR abnormal rate was higher in hyperuricemia group( P＜0.01 ). ACR level was positively correlated with SUA( P＜0.01 ). The general linear model showed that SUA was a risk factor in ACR. Patients with hyperuricemia and type 2 diabetes mellitus were apt to have abnormal ACR and develop early renal damage.

Relationship of the level of serum C peptide with albumin-to-creatinine ratio and nerve conduction velocity in type 2 diabetes mellitus / 中国糖尿病杂志

Objective To investigate the relationship of the level of serum C-peptide(C-P)with albumin-to-creatinine ratio(ACR)and nerve conduction velocity(NCV)in patients with T2DM.Methods The study included 132 patients with T2DM and 30 healthy controls.The NCV,ACR,fasting C-P and C-P at 2hOGTT(FC-P and 2hC-P)and plasma glucose(PG)were measured.The patients were separated into three groups of Ⅰ(45 cases),Ⅱ(52 cases)and Ⅲ(35 cases).The patients were further classified into two groups of normal NCV(70 cases)and abnormal NCV(62 cases).Results ①The differences of FC-P and 2hC-P among the ACR groups were significant(all P<0.05).②The ACR was correlated with course,2hC-P,2hPG significantly(all P<0.01).The sequence of the impact degree on ACR was from course(Beta:0.592)to 2hC-P(Beta:-0.297)and to 2hPG(Beta:0.201).③The levels of serum 2hC-P were significantly and gradually decreased in the groups of NCV(P<0.01).④The serum 2hC-P concentration was associated with ACR and NCV in different stages(P<0.01).Conclusions ①The level of serum C-P is tightly correlated with the vascular and neural dysfunction in T2DM.②Course,2hPG and 2hC-P may be the risk factors for ACR