title: Albuminuria as a risk factor for peripheral arterial disease in a general population: the Hisayama study.
abstract: OBJECTIVE
  To elucidate the relationship between albuminuria and the prevalence of peripheral arterial disease (PAD), and to examine the effect of albuminuria on the ability to assess the likelihood of PAD in a general Japanese population.
  
  
  METHODS
  In 3,061 community-dwelling subjects aged. 40 years, we investigated the association of urinary albumin-creatinine ratio (UACR) levels with the prevalence of PAD, defined as an ankle-brachial index < 0.9. The odds ratio for the presence of PAD was estimated using the logistic regression model. To compare the accuracy of the assessment for the likelihood of prevalent PAD between models adjusted for potential risk factors with and without UACR levels, the receiver operating characteristic (ROC) curves were plotted.
  
  
  RESULTS
  Overall, 1.47% of the study participants had PAD. The age- and sex-adjusted prevalence of PAD increased linearly for UACR levels of < 5.6, 5.6-10.8, 10.9-29.9, 30.0-300.0, and >300.0 mg/g, being 0.34, 0.80, 2.02, 2.50, and 2.53%, respectively (p for trend <0.001). The multivariate-adjusted odds ratio for the presence of PAD was 1.85 (95% confidence interval 1.12-3.06) for every 10-fold increment in UACR. The area under the ROC curve significantly increased when UACR levels were incorporated into a model with potential risk factors for PAD (0.80 vs. 0.77, p= 0.02).
  
  
  CONCLUSIONS
  Greater UACR levels are associated linearly with a higher prevalence of PAD, even within the normoalbuminuric range, in the general Japanese population, and combining UACR levels with potential risk factors substantially improves the performance to assess the likelihood of PAD.
authors.affiliation: Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Usui
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Ninomiya
authors.forename: Masaharu
authors.initials: M
authors.lastname: Nagata
authors.forename: Yasufumi
authors.initials: Y
authors.lastname: Doi
authors.forename: Jun
authors.initials: J
authors.lastname: Hata
authors.forename: Masayo
authors.initials: M
authors.lastname: Fukuhara
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kiyohara
mesh_terms: D000328:Adult; D000368:Aged; D000418:Albumins / Q000096:biosynthesis; D000419:Albuminuria / Q000175:diagnosis* / Q000652:urine; D003404:Creatinine / Q000652:urine; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D016491:Peripheral Vascular Diseases / Q000175:diagnosis* / Q000652:urine; D015995:Prevalence; D012372:ROC Curve; D012307:Risk Factors
chemical_list: D000418:Albumins; D003404:Creatinine