Urine Albumin Creatinine Ratio is Associated with Carotid Atherosclerosis in a Community Based Cohort: Atherosclerosis Risk of Rural Area in Korean General Population Study.
BACKGROUND
Albuminuria is a surrogate marker of endothelial dysfunction and a predictor of cardiovascular events. Data are limited with regard to the relationship between albuminuria and subclinical atherosclerosis in a community-based cohort. We determined the association between albuminuria measured by the urine albumin creatinine ratio (UACR) and carotid intima media thickness (CIMT) in a Korean rural population.


METHODS
We enrolled 1,369 healthy subjects older than 40 years (857 males and 518 females) with normal renal function and measured the CIMT. We excluded subjects with overt proteinuria (> 300 mg/day) or with treatment of diabetes mellitus, hypertension, dyslipidemia, and any cardiovascular disease. The subjects were stratified into the quartile value of the UACR (lowest quartile: UACR < 4.8 and highest quartile: UACR > 17.7). And we evaluate the relationship between UACR and CIMT by linear regression and logistic regression analysis.


RESULTS
Increasing quartile of the UACR had a stepwise increase in body mass index, blood pressure, cholesterol profile [low density lipoprotein (LDL)-cholesterol and triglyceride], glucose, homeostratic model assessment of insulin resistance (HOMA-IR), and C-reactive protein (all p values < 0.001). Maximal CIMT from the 1(st) to the 4(th) quartile values of the UACR were 0.74 ± 0.17, 0.77 ± 0.18, 0.78 ± 0.18, and 0.82 ± 0.21 mm, respectively (p < 0.001). In a multivariate regression model adjusted for age, sex, systolic blood pressure, triglyceride, LDL-cholesterol, fasting blood sugar, waist circumference, adiponectin, HOMA-IR, high sensitive C-reactive protein, smoking, UACR showed a significant association with maximal CIMT (B = 0.014, R(2) = 0.145, p = 0.002).


CONCLUSIONS
Albuminuria measured by the UACR was significantly associated with both CIMT and traditional risk factors of atherosclerosis except for smoking in healthy Koreans.
Devision of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.
Joong Kyung
JK
Sung
Jang-Young
JY
Kim
Young Jin
YJ
Youn
Jun Won
JW
Lee
Sung Gyun
SG
Ahn
Byung Su
BS
Yoo
Seung Hwan
SH
Lee
Junghan
J
Yoon
Kyung-Hoon
KH
Choe
Jin Ha
JH
Yoon
Jong Ku
JK
Park
Sang Baek
SB
Koh
JAMA. 2001 Jul 25;286(4):421-6
11466120
J Am Coll Cardiol. 2003 Jun 4;41(11):2022-8
12798576
N Engl J Med. 2004 Sep 23;351(13):1296-305
15385656
N Engl J Med. 1999 Jan 7;340(1):14-22
9878640
Eur Heart J. 2007 Jun;28(12):1462-536
17562668
Eur Heart J. 2005 Feb;26(3):279-87
15618058
Circulation. 2005 Aug 16;112(7):969-75
16087792
Clin Sci (Lond). 1995 Jun;88(6):629-33
7634745
Arterioscler Thromb Vasc Biol. 1999 Aug;19(8):1992-7
10446083
Circulation. 2002 Oct 1;106(14):1777-82
12356629
Lancet. 1982 Jun 26;1(8287):1430-2
6123720
Eur Heart J. 2007 Feb;28(3):363-9
17132646
Am J Kidney Dis. 1999 Nov;34(5):918-25
10561150
Atherosclerosis. 2002 Sep;164(1):161-6
12119205
BMJ. 1998 Feb 14;316(7130):504-9
9501711