title: COPD and microalbuminuria: a 12-year follow-up study.
abstract: Chronic obstructive pulmonary disease (COPD), low lung function independent of diagnosis and markers of inflammation are all associated with increased morbidity and mortality. Microalbuminuria, reflecting endothelial dysfunction, could be a relevant inflammatory marker of potential systemic effects of COPD. We hypothesised that there was a positive association between microalbuminuria and mortality in individuals with COPD. We conducted a 12-year follow-up study of 3129 participants in the second survey of the Nord-Trøndelag Health Study (HUNT), Norway. At baseline, albuminuria was analysed in three urine samples and spirometry was performed. Among the participants, 136 had COPD and microalbuminuria, defined as a urinary albumin/creatinine ratio between 2.5 and 30.0 mg·mmol(-1). The main outcome measures were hazard ratio of all-cause mortality according to microalbuminuria. Compared to those with COPD without microalbuminuria, the adjusted hazard ratio for all-cause mortality in those with COPD and microalbuminuria was 1.54, 95% CI 1.16-2.04. This result was similar after excluding cardiovascular disease at baseline. Classifying COPD severity by Global Initiative for Chronic Obstructive Lung Disease, there was a positive association trend with increasing severity stages. Microalbuminuria is associated with all-cause mortality in individuals with COPD and could be a relevant tool in identification of patients with poor prognosis.
authors.affiliation: Health Trust Nord-Trøndelag, Dept of Internal Medicine, Levanger.
authors.forename: Solfrid
authors.initials: S
authors.lastname: Romundstad
authors.forename: Thor
authors.initials: T
authors.lastname: Naustdal
authors.forename: Pål Richard
authors.initials: PR
authors.lastname: Romundstad
authors.forename: Hanne
authors.initials: H
authors.lastname: Sorger
authors.forename: Arnulf
authors.initials: A
authors.lastname: Langhammer
mesh_terms: D000328:Adult; D000368:Aged; D000418:Albumins / Q000032:analysis; D000419:Albuminuria / Q000150:complications / Q000503:physiopathology*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D015415:Biomarkers; D015992:Body Mass Index; D003404:Creatinine / Q000652:urine; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation; D008297:Male; D008875:Middle Aged; D009664:Norway; D011379:Prognosis; D016016:Proportional Hazards Models; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000503:physiopathology*; D012044:Regression Analysis; D012720:Severity of Illness Index; D013147:Spirometry; D016896:Treatment Outcome
chemical_list: D000418:Albumins; D000893:Anti-Inflammatory Agents; D015415:Biomarkers; D003404:Creatinine