title: Albuminuria in Rheumatoid Arthritis: Associations With Rheumatoid Arthritis Characteristics and Subclinical Atherosclerosis.
abstract: Albuminuria is a marker for subclinical cardiovascular disease (CVD) in the general population. It is uncertain whether this association is present in patients with rheumatoid arthritis (RA), a population with increased atherosclerosis and CVD events.
  
  
  
  Urine albumin from a spot morning collection was measured, and the urine albumin-to-creatinine ratio (uACR) was calculated for RA patients and a population-based sample of demographically matched non-RA controls. Associations of elevated uACR (≥25 mg/gm for women and ≥17 mg/gm for men) with CVD risk factors and measures of atherosclerosis (coronary artery calcification, ultrasound-determined maximal intima-media thickness of the common carotid artery and internal carotid artery [ICA], and the presence of focal plaque in the ICA) were compared cross-sectionally according to RA status.
  
  
  
  We compared 196 RA patients with 271 non-RA controls. Elevated uACR was found in 18% of the RA patients compared with 17% of the controls (P = 0.89). After adjustment, RA was associated with 57% lower odds of elevated uACR (P = 0.016). Higher serum creatinine levels and hypertension were both strongly and significantly associated with elevated uACR in the control group but not in the RA group (both P for interaction < 0.05). Among RA characteristics, the adjusted prevalence of elevated uACR among those treated with tumor necrosis factor inhibitors was less than half that among those not so treated (9% versus 20%, respectively; P = 0.047).
  
  
  
  There was no association in the RA group of elevated uACR with measures of atherosclerosis or with several key cardiometabolic risk factors, which suggests a lower usefulness of elevated uACR as an indicator of subclinical CVD in RA.
authors.affiliation: Columbia University College of Physicians & Surgeons, New York, New York.
authors.forename: Amanda
authors.initials: A
authors.lastname: Sammut
authors.affiliation: Columbia University College of Physicians & Surgeons, New York, New York.
authors.forename: Steven
authors.initials: S
authors.lastname: Shea
authors.affiliation: Johns Hopkins University, Baltimore, Maryland.
authors.forename: Roger S
authors.initials: RS
authors.lastname: Blumenthal
authors.affiliation: Johns Hopkins University, Baltimore, Maryland.
authors.forename: Moyses
authors.initials: M
authors.lastname: Szklo
authors.affiliation: Columbia University College of Physicians & Surgeons, New York, New York.
authors.forename: Joan M
authors.initials: JM
authors.lastname: Bathon
authors.affiliation: Tufts University School of Medicine, Boston, Massachusetts.
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Polak
authors.affiliation: University of Vermont College of Medicine, Burlington, Vermont.
authors.forename: Russell
authors.initials: R
authors.lastname: Tracy
authors.affiliation: Columbia University College of Physicians & Surgeons, New York, New York.
authors.forename: Jon T
authors.initials: JT
authors.lastname: Giles
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000175:diagnosis / Q000453:epidemiology* / Q000652:urine; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D058070:Asymptomatic Diseases; D001688:Biological Products / Q000627:therapeutic use; D015415:Biomarkers / Q000652:urine; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology*; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000453:epidemiology*; D003404:Creatinine / Q000652:urine; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D058226:Plaque, Atherosclerotic; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D016482:Urinalysis; D061205:Vascular Calcification / Q000000981:diagnostic imaging / Q000453:epidemiology*
chemical_list: D001688:Biological Products; D015415:Biomarkers; D003404:Creatinine