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首页> 外文期刊>Kidney and blood pressure research >Low-Grade Albuminuria Is Associated with Left Ventricular Hypertrophy and Diastolic Dysfunction in Patients with Hypertension
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Low-Grade Albuminuria Is Associated with Left Ventricular Hypertrophy and Diastolic Dysfunction in Patients with Hypertension

机译：低度白蛋白尿与高血压患者左室肥厚和舒张功能障碍有关

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Introduction: Microalbuminuria is a risk factor for cardiovascular morbidity and mortality in hypertensive patients. However, the relationship between low-grade albuminuria, a higher level of albuminuria below microalbuminuria threshold, and hypertension-related organ damage is unclear. Left ventricular (LV) hypertrophy (LVH) is well recognized to be a subclinical organ damage of hypertension, and LV diastolic dysfunction is also reported to be an early functional cardiac change of hypertension that predicts heart failure. The present study aimed to investigate the association of low-grade albuminuria with LVH and LV diastolic dysfunction in hypertensive patients. Methods: This cross-sectional observational clinical study was retrospectively performed in 870 hypertensive patients admitted to our hospital. Urinary albumin to creatinine ratio (UACR) was calculated to assess the levels of albuminuria: macroalbuminuria (≥300 mg/g), microalbuminuria (≥30 mg/g, but 300 mg/g), and normal albuminuria (30 mg/g). Low-grade albuminuria was defined as sex-specific highest tertile within normal albuminuria (8.1–29.6 mg/g in males and 11.8–28.9 mg/g in females). LVH and LV diastolic dysfunction were identified as recommended by American Society of Echocardiography. Results: Of the 870 patients, 765 (87.9%) had normal albuminuria, 77 (8.9%) had microalbuminuria, and 28 (3.2%) had macroalbuminuria. Percentage of LVH and LV diastolic dysfunction was increased with ascending UACR. UACR was independently associated with LVH and LV diastolic dysfunction, even in patients with normal albuminuria. Multivariable logistic regression showed that the patients with the highest tertile within normal albuminuria had nearly 80% increase in LVH and nearly 60% increase in LV diastolic dysfunction (adjusted OR for LVH 1.788, 95% CI 1.181–2.708, p = 0.006; adjusted OR for LV diastolic dysfunction 1.567, 95% CI 1.036–2.397, p = 0.034). After further stratification analyses in patients with normal albuminuria, it was shown that this independent association persisted in female patients, those who were younger than 70 years old, and those with duration of hypertension 15 years. Conclusion: Low-grade albuminuria was associated with LVH and LV diastolic dysfunction in hypertensive patients, especially in patients younger than 70 years old, and those with duration of hypertension 15 years.
机译：简介：微量白蛋白尿是高血压患者心血管疾病发病率和死亡率的危险因素。但是，低度白蛋白尿，低于微量白蛋白尿阈值的较高蛋白尿水平与高血压相关器官损害之间的关系尚不清楚。左心室肥大（LVH）被公认为是高血压的亚临床器官损害，并且LV舒张功能障碍也据报道是高血压的早期心脏功能改变，可预测心力衰竭。本研究旨在探讨高血压患者低度白蛋白尿与LVH和LV舒张功能障碍的关系。方法：对本院收治的870例高血压患者进行回顾性的横断面观察性临床研究。计算尿白蛋白/肌酐比值（UACR）以评估白蛋白尿的水平：大白蛋白尿（≥300mg / g），微白蛋白尿（≥30mg / g，但<300 mg / g）和正常白蛋白尿（<30 mg / G）。低度白蛋白尿定义为正常白蛋白尿中的性别特异性最高三分位数（男性为8.1–29.6 mg / g，女性为11.8–28.9 mg / g）。 LVH和LV舒张功能障碍是由美国超声心动图学会推荐的。结果：在870例患者中，765名（87.9％）患有正常的白蛋白尿，77名（8.9％）患有微量白蛋白尿，28名（3.2％）患有大量白蛋白尿。随着UACR的升高，LVH和LV舒张功能障碍的百分比增加。 UACR与LVH和LV舒张功能障碍独立相关，即使在蛋白尿正常的患者中也是如此。多变量逻辑回归分析显示，正常蛋白尿中三分位数最高的患者的LVH增加近80％，LV舒张功能障碍增加近60％（LVH的校正值OR为1.788，95％CI为1.181–2.708，p = 0.006;校正后的OR左室舒张功能不全1.567，95％CI 1.036–2.397，p = 0.034）。经过对正常蛋白尿患者的进一步分层分析，结果表明，这种独立的联系在女性患者，小于70岁的年轻人和高血压持续时间小于15岁的患者中仍然存在。结论：低度白蛋白尿与高血压患者的LVH和LV舒张功能障碍有关，尤其是70岁以下和高血压病程<15岁的患者。

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