title: Three-year incidence of elevated albuminuria and associated factors in a population-based cohort: The Taichung Community Health Study.
abstract: BACKGROUND
  early-stage elevated albuminuria can be effectively detected by a spot urine albumin-to-creatinine ratio (UACR). Elevated albuminuria is a key predictor of diabetic nephropathy, progression to chronic kidney disease (CKD) or end-stage renal disease (ESRD), plus risk of cardiovascular disease (CVD) and mortality. Understanding these detectors may prevent future renal and cardiovascular disease. This study estimates three-year incidence in a representative sample of Taiwanese metropolitan adults to explore predictors.
  
  
  METHODS
  the Taichung Community Health Study (TCHS) is a representative sample of 2359 Chinese adults aged 40 years and over living in a metropolitan city during 2004-2005. In 2007-2009, a total of 1648 (71.3%) individuals participated in follow-up. This study includes only individuals with normal albumin excretion at baseline examination. Three-year incidence and baseline factors linked with elevated albuminuria were evaluated.
  
  
  RESULTS
  about 87.0% (n = 1434) of subjects exhibited normal albumin excretion at baseline. Three-year age- and gender-weighted incidence was 4.5% (95% CI: 3.4-5.6%). Multivariate logistic regression showed subjects with elevated waist-to-hip ratio (WHR) (OR: 2.2, 95% CI: 1.2-3.9), abnormal creatinine (OR: 3.7, 95% CI: 1.1-12.6), hyperuricaemia (OR: 1.8, 95% CI: 1.0-3.3) and elevated baseline UACR (OR: 4.0, 95% CI: 1.1-14.3 for UACR of 3.20-6.39 mg/g; OR: 16.7, 95% CI: 5.0-55.5 for UACR of 6.40-29.99 mg/g) were more likely to have elevated albuminuria.
  
  
  CONCLUSIONS
  this is the first population-based longitudinal study to rate incidence of elevated albuminuria and identify associated factors in a random sample of a Chinese population. Central obesity, renal function, hyperuricaemia and baseline UACR are independent risk factors.
authors.affiliation: Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan.
authors.forename: Li-Na
authors.initials: LN
authors.lastname: Liao
authors.affiliation: Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Chiu-Shong
authors.initials: CS
authors.lastname: Liu
authors.affiliation: School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.
authors.forename: Chia-Ing
authors.initials: CI
authors.lastname: Li
authors.affiliation: Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Wen-Yuan
authors.initials: WY
authors.lastname: Lin
authors.affiliation: Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan PhD Program for Aging, College of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Chih-Hsueh
authors.initials: CH
authors.lastname: Lin
authors.affiliation: Graduate Institute of Biostatistics, College of Management, China Medical University, Taichung, Taiwan Department of Healthcare Administration, College of Health Science, Asia University, Taichung, Taiwan tcli@mail.cmu.edu.tw.
authors.forename: Tsai-Chung
authors.initials: TC
authors.lastname: Li
authors.affiliation: Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Cheng-Chieh
authors.initials: CC
authors.lastname: Lin
mesh_terms: D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000175:diagnosis / Q000208:ethnology* / Q000503:physiopathology; D044466:Asian People; D015415:Biomarkers / Q000652:urine; D016009:Chi-Square Distribution; D002681:China / Q000208:ethnology; D003404:Creatinine / Q000652:urine; D018450:Disease Progression; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D033461:Hyperuricemia / Q000208:ethnology; D015994:Incidence; D007668:Kidney / Q000503:physiopathology; D008019:Life Style / Q000208:ethnology; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D056128:Obesity, Abdominal / Q000208:ethnology; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors; D014504:Urban Health; D016482:Urinalysis
chemical_list: D015415:Biomarkers; D003404:Creatinine
keywords: Albuminuria; incidence; population-based