title: Urinary albumin excretion in patients with rheumatoid arthritis in a large cross-sectional study.
abstract: While there is a lot of evidence published on the association of cardiovascular (CV) disease and rheumatoid arthritis (RA), little is known about urinary albumin excretion (UAE)-a marker of CV risk-in this particular high-risk population. Therefore, we investigated UAE in a large cross-sectional study. We used data from the US National Health and Nutrition Examination Survey (NHANES), including the years 2007-2012. Primary outcome was the proportion of patients with a urinary albumin-creatinine ratio (ACR) >30 mg/g. A total of 14,648 study participants (representing a population size of 174,663,008) with available ACR were included in the study (14,179 without RA and 469 with RA). In the RA group, the proportion of patients with an ACR >30 mg/g was 10.46 % (95 % CI 7.47-14.45 %) and in the non-RA group this proportion was 13.39 % (95 % CI 12.65-14.16 %; p = 0.09). There was a strong association between RA and DM (OR 5.84; 95 % CI 4.48-7.62). In the RA group, significantly more patients had a former CV event (OR 3.01; 95 % CI 2.28-3.97). Adjustments for DM, smoking status, former CV event, age, systolic blood pressure, and gender did not substantially alter the association between RA and ACR >30 mg/g (OR 0.82; 95 % CI 0.51-1.33). We did not find evidence for a difference in UAE in patients with or without RA, despite the fact that RA was associated with DM and, in addition, RA patients more often had a previous CV event. These findings may support the assumption that despite an increased CV risk, UAE does not play a major role in RA patients.
authors.affiliation: Academic Research Unit, 2nd Department of Medicine, Kepler University Hospital, Med Campus III, Krankenhausstr. 9, A-4020, Linz, Austria. herwigpi@yahoo.com.|Paracelsus Private Medical University Salzburg, Müllner Hauptstraße 48, A-5020, Salzburg, Austria. herwigpi@yahoo.com.
authors.forename: Herwig
authors.initials: H
authors.lastname: Pieringer
authors.affiliation: Department of Internal Medicine I, Klinikum Wels Grieskirchen, 4600, Wels, Austria.
authors.forename: Kathrin
authors.initials: K
authors.lastname: Danninger
authors.affiliation: , Freiung 19, 4600, Wels, Austria.
authors.forename: Rudolf
authors.initials: R
authors.lastname: Puchner
authors.affiliation: Department of Internal Medicine II, Salzburger Landeskliniken, Paracelsus Medical University Salzburg, Salzburg, Austria.
authors.forename: Uta C
authors.initials: UC
authors.lastname: Hoppe
authors.affiliation: Academic Research Unit, 2nd Department of Medicine, Kepler University Hospital, Med Campus III, Krankenhausstr. 9, A-4020, Linz, Austria.
authors.forename: Erich
authors.initials: E
authors.lastname: Pohanka
mesh_terms: D000328:Adult; D000419:Albuminuria / Q000150:complications*; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000652:urine*; D002318:Cardiovascular Diseases / Q000209:etiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D012307:Risk Factors
keywords: Cardiovascular; NHANES; Rheumatoid arthritis; Urinary albumin excretion