title: Exercise-induced albuminuria is related to metabolic syndrome.
abstract: Microalbuminuria (MA) is a known marker for endothelial dysfunction and future cardiovascular events. Exercise-induced albuminuria (EiA) may precede the appearance of MA. Associations between EiA and metabolic syndrome (MS) have not been assessed so far. Our aim was to investigate this association in a large sample of apparently healthy individuals with no baseline albuminuria. This was a cross-sectional study of 2,027 adults with no overt cardiovascular diseases who took part in a health survey program and had no baseline MA. Diagnosis of MS was based on harmonized criteria. All patients underwent an exercise test (Bruce protocol), and urinary albumin was measured before and after the examination. Urinary albumin-to-creatinine ratio (ACR) values before and after exercise were 0.40 (0.21-0.89) and 1.06 (0.43-2.69) mg/g for median (interquartile range) respectively. A total of 394 (20%) subjects had EiA; ACR rose from normal rest values (0.79 mg/g) to 52.28 mg/g after exercise (P < 0.001); this effect was not shown for the rest of the study population. EiA was related to higher prevalence of MS (13.8% vs. 27.1%, P < 0.001), higher metabolic equivalents (P < 0.001), higher baseline blood pressure (P < 0.001), and higher levels of fasting plasma glucose, triglycerides, and body mass index (P < 0.001). Multivariate binary logistic regression model showed that subjects with MS were 98% more likely to have EiA (95% confidence interval: 1.13-3.46, P = 0.016). In conclusion, EiA in the absence of baseline MA is independently related to MS.
authors.affiliation: Department of Internal Medicine "E," Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; sharon.greenberg@gmail.com.
authors.forename: Sharon
authors.identifier: 0000-0001-7346-1746
authors.initials: S
authors.lastname: Greenberg
authors.affiliation: Department of Internal Medicine "E," Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel;
authors.forename: Shani
authors.initials: S
authors.lastname: Shenhar-Tsarfaty
authors.affiliation: Department of Internal Medicine "C," Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel;
authors.forename: Ori
authors.initials: O
authors.lastname: Rogowski
authors.affiliation: Department of Cardiology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; and.
authors.forename: Itzhak
authors.initials: I
authors.lastname: Shapira
authors.affiliation: Department of Internal Medicine "D," Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel;
authors.forename: David
authors.initials: D
authors.lastname: Zeltser
authors.affiliation: Department of Nephrology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Talia
authors.initials: T
authors.lastname: Weinstein
authors.affiliation: Department of Internal Medicine "E," Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel;
authors.forename: Dror
authors.initials: D
authors.lastname: Lahav
authors.affiliation: Department of Internal Medicine "E," Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel;
authors.forename: Jaffa
authors.initials: J
authors.lastname: Vered
authors.affiliation: Department of Cardiology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; and.
authors.forename: Oholi
authors.initials: O
authors.lastname: Tovia-Brodie
authors.affiliation: Department of Cardiology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; and.
authors.forename: Yaron
authors.initials: Y
authors.lastname: Arbel
authors.affiliation: Department of Internal Medicine "E," Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel;
authors.forename: Shlomo
authors.initials: S
authors.lastname: Berliner
authors.affiliation: Department of Internal Medicine "E," Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel;
authors.forename: Assi
authors.initials: A
authors.lastname: Milwidsky
mesh_terms: D000328:Adult; D000419:Albuminuria / Q000150:complications / Q000503:physiopathology* / Q000652:urine; D003404:Creatinine / Q000652:urine; D003430:Cross-Sectional Studies; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000503:physiopathology* / Q000652:urine; D008875:Middle Aged
chemical_list: D003404:Creatinine
keywords: exercise-induced albuminuria; metabolic syndrome; stress test