Association of microalbuminuria with the risk factors of stroke and recurrence in patients with cerebral infarction

Qin YANG; Weiwei DONG

ABSTRACT

BACKGROUND:

International research discovers that the risk factors of stroke have certain correlation with microalbuminuria(MAU) but the results are inconsistent.

OBJECTIVE:

To investigate the relationship between the incidence of MAU in patients with acute cerebral infarction and the risk factor of stroke and the recurrence of cerebral infarction.

DESIGN:

A case-control study based on patients with acute cerebral infarction and individuals with risk factors of cerebral infarction, and the healthy elderly as controls.

SETTING:

Inpatient department of neurology in a university hospital.

PARTICIPANTS:

Totally 214 cases with cerebral infarction or risk factors of cerebral infarction aged between 50 and 80 years old were selected from the Department of Neurology of the First Affiliated Hospital of Chongqing Medical University between January 2000 and December 2001. Acute cerebral infarction group (infarction group, attack within one week, n =78), cerebral infarction risk factor group(risk group, n = 56), such as, hypertension, diabetes,coronary heart disease (CHD), transient ischemic attack(TIA) or stroke history(more than 6 months), and healthy elderly(control group, n=28) .Thereinto, combined group( n = 109) included 78 cases of acute cerebral infarction and 31 cases with TIA or stroke history of risk factors.

METHODS:

Seralbumin, serum creatine(SCr), blood sugar, total cholesterol, total triacylglycerol(TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol(LDL-C) were detected after more than 12 hours of fasting. The albumin in the first urine in the morning was detected by radio-immunity analysis.the incidence of neo-vascular affair in 2 years of follow-up including recurtute indicator incidence of MAU in each group.

RESULTS:

Patients with MAU accounted for 35% of acute cerebral infarction, which were significantly higher than that of risk group(15% ) and control group(3.5%, P ＜ 0.01). Six independent risk factors predicting MAU existed in infarction group and combined group, which were diabetes, seralbumin level, age, CHD, hypertension, and HDL-C( P ＜ 0. 05, or P ＜ 0.01).After(1.5 ±0. 9) years of follow-up, 23% of patients of infarction group suffered from recurrent vascular accident, which was significantly higher than that of risk group(12% ) and control group(0%, P ＜ 0.01 ). 36% of MAU patients in infarction group suffered from recurrent vascular accident, which was significantly different from that of patients with a great deal of albuminuria(41% ) and normal albuminuria(10%, P ＜ 0. 05). MAU is the independent predicting indicator for the recurrence of stroke after the control of diabetes and hypertension in patients of infarction group and risk group with the risk rate of 3.8 (95% CI, 1.2-13.5; P ＜0.05) or 4. 7(95%CI,1.4-16.7, P ＜ 0.01).

CONCLUSION:

MAU is quite common in acute cerebral infarction patients. After the adjustment of basic risk factors, MAU is the independent risk factor of the recurrence of cerebral infarction.