title: Gender- and race-specific determination of albumin excretion rate using albumin-to-creatinine ratio in single, untimed urine specimens: the Coronary Artery Risk Development in Young Adults Study.
abstract: Although albumin excretion rate is commonly estimated by using albumin/creatinine ratio (A/C), gender and race differences in creatinine excretion may bias this estimate. The authors optimize the use of an untimed (spot) urine specimen among 3,371 Blacks and Whites aged 28-40 years in the Coronary Artery Risk Development in Young Adults Study in 1995-1996. Using three 24-hour collections during the year 5 examination, they determined k = 0.68 x 0.88 in Black men, 0.88 in Black women, 0.68 in White men, and 1.0 in White women to reflect gender and race differences in creatinine excretion. The authors then computed A/C adjusted for race and sex differences in creatinine excretion (A/kC) by using an untimed urine sample in the year 10 examination. A/kC >or= 25 mg/g (194 cases of microalbuminuria and 26 cases of clinical grade albuminuria) was more common among Blacks (9.1%) than among Whites (4.2%) and among men (8.2%) than among women (5.0%). Use of the unadjusted A/C underestimated the prevalence of microalbuminuria among men by 52% and among Blacks by 26%. Adjustment of A/C permitted more accurate estimation of albumin excretion rate. Men and Blacks have a higher albumin excretion rate than do women and Whites and may thereby have an increased risk of microvascular and macrovascular disease.
authors.affiliation: University of Minnesota, Division of Epidemiology, School of Public Health, Minneapolis, MN 55454, USA. jacobs@epi.umn.edu
authors.forename: David R
authors.initials: DR
authors.lastname: Jacobs
authors.forename: Maureen A
authors.initials: MA
authors.lastname: Murtaugh
authors.forename: Michael
authors.initials: M
authors.lastname: Steffes
authors.forename: Xinhua
authors.initials: X
authors.lastname: Yu
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Roseman
authors.forename: Frederick C
authors.initials: FC
authors.lastname: Goetz
mesh_terms: D000328:Adult; D000419:Albuminuria / Q000453:epidemiology / Q000378:metabolism*; D044383:Black People; D003327:Coronary Disease / Q000209:etiology; D003404:Creatinine / Q000652:urine*; D005260:Female; D006801:Humans; D008297:Male; D015337:Multicenter Studies as Topic; D012307:Risk Factors; D012737:Sex Factors; D044465:White People
chemical_list: D003404:Creatinine