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Abstract：
To study the development of microalbuminuria (MAU) in essential hypertension (EHT), we investigated the association of MAU with central blood pressure (CBP), direct renin concentration (DRC), plasma aldosterone (PA), and uric acid (UA).
We determined 24 h-urinary albumin excretion (24 h-UAE) in patients with EHT who were hospitalized at TEDA International Cardiovascular Hospital from June 2020 to May 2022. We defined MAU as 24 h-UAE in the range of 30 mg/24 h to 300 mg/24 h. Univariate and multivariate analyses were conducted to determine the associations of MAU with CBP, DRC, PA, and UA in EHT, considering demographic and clinical information. We also plotted receiver operating characteristic curves (ROCs) for predicting MAU using these results.
More than a quarter of patients (26.5%, 107/404, 95% CI: 22.2-31.1%) were diagnosed with MAU in EHT. A higher body mass index (BMI), longer duration of hypertension, and higher severity were associated with MAU. Also, nearly 10% more creatinine levels were recorded in the MAU group than in the control group (69.5 ± 18.7 µmol/L vs. 64.8 ± 12.5 µmol/L, P = 0.004). The increase was also observed for PA (15.5, 9.7-20.6 ng/dL vs. 12.3, 9.0-17.3 ng/dL, P = 0.024) and UA (419.8 ± 105.6 µmol/L vs. 375.1 ± 89.5 µmol/L, P < 0.001) in the MAU group compared to that in the control group. Several variables were associated with MAU, including central diastolic blood pressure (CDBP) (OR = 1.017, 95% CI: 1.002-1.032, P = 0.027), PA (OR = 1.043, 95% CI: 1.009-1.078, P = 0.012) and UA (OR = 1.005, 95% CI: 1.002-1.008, P < 0.001). For MAU prediction, the area under the curve (AUC) was 0.709 (95% CI: 0.662-0.753; P < 0.001) when CDBP, PA, and UA were used in combination, and the optimal probability of the cut-off value was 0.337.
We found that CDBP, PA, and UA, used for MAU prediction, might be associated with its development during EHT.
We determined 24 h-urinary albumin excretion (24 h-UAE) in patients with EHT who were hospitalized at TEDA International Cardiovascular Hospital from June 2020 to May 2022. We defined MAU as 24 h-UAE in the range of 30 mg/24 h to 300 mg/24 h. Univariate and multivariate analyses were conducted to determine the associations of MAU with CBP, DRC, PA, and UA in EHT, considering demographic and clinical information. We also plotted receiver operating characteristic curves (ROCs) for predicting MAU using these results.
More than a quarter of patients (26.5%, 107/404, 95% CI: 22.2-31.1%) were diagnosed with MAU in EHT. A higher body mass index (BMI), longer duration of hypertension, and higher severity were associated with MAU. Also, nearly 10% more creatinine levels were recorded in the MAU group than in the control group (69.5 ± 18.7 µmol/L vs. 64.8 ± 12.5 µmol/L, P = 0.004). The increase was also observed for PA (15.5, 9.7-20.6 ng/dL vs. 12.3, 9.0-17.3 ng/dL, P = 0.024) and UA (419.8 ± 105.6 µmol/L vs. 375.1 ± 89.5 µmol/L, P < 0.001) in the MAU group compared to that in the control group. Several variables were associated with MAU, including central diastolic blood pressure (CDBP) (OR = 1.017, 95% CI: 1.002-1.032, P = 0.027), PA (OR = 1.043, 95% CI: 1.009-1.078, P = 0.012) and UA (OR = 1.005, 95% CI: 1.002-1.008, P < 0.001). For MAU prediction, the area under the curve (AUC) was 0.709 (95% CI: 0.662-0.753; P < 0.001) when CDBP, PA, and UA were used in combination, and the optimal probability of the cut-off value was 0.337.
We found that CDBP, PA, and UA, used for MAU prediction, might be associated with its development during EHT.
摘要：
目的：研究原发性高血压（EHT）中微量白蛋白尿（MAU）的发展。我们调查了MAU与中心血压（CBP）的关系，直接肾素浓度（DRC），血浆醛固酮(PA),尿酸（UA）。
方法：我们测定了2020年6月至2022年5月在泰达国际心血管病医院住院的EHT患者的24h尿白蛋白排泄量（24h-UAE）。我们将MAU定义为24h-UAE，范围为30mg/24h至300mg/24h。进行单变量和多变量分析以确定MAU与CBP的关联。DRC,PA,和UA在EHT中，考虑人口统计学和临床信息。我们还绘制了接收器工作特征曲线（ROC），用于使用这些结果预测MAU。
结果：超过四分之一的患者（26.5%，107/404，95%CI：22.2-31.1%）在EHT中诊断为MAU。较高的体重指数（BMI），高血压持续时间较长，和更高的严重程度与MAU相关。此外，MAU组的肌酐水平比对照组多近10％（69.5±18.7µmol/Lvs.64.8±12.5µmol/L,P=0.004)。PA也增加（15.5，9.7-20.6ng/dL与12.3,9.0-17.3ng/dL,P=0.024）和UA（419.8±105.6µmol/L与375.1±89.5µmol/L,与对照组相比，MAU组的P<0.001）。几个变量与MAU相关，包括中央舒张压(CDBP)(OR=1.017,95%CI:1.002-1.032,P=0.027),PA(OR=1.043,95%CI:1.009-1.078,P=0.012)和UA(OR=1.005,95%CI:1.002-1.008,P<0.001)。对于MAU预测，CDBP时曲线下面积(AUC)为0.709(95%CI:0.662-0.753,P<0.001),PA,和UA结合使用，截止值的最优概率为0.337。
结论：我们发现CDBP，PA,UA,用于MAU预测，可能与EHT期间的发展有关。
方法：我们测定了2020年6月至2022年5月在泰达国际心血管病医院住院的EHT患者的24h尿白蛋白排泄量（24h-UAE）。我们将MAU定义为24h-UAE，范围为30mg/24h至300mg/24h。进行单变量和多变量分析以确定MAU与CBP的关联。DRC,PA,和UA在EHT中，考虑人口统计学和临床信息。我们还绘制了接收器工作特征曲线（ROC），用于使用这些结果预测MAU。
结果：超过四分之一的患者（26.5%，107/404，95%CI：22.2-31.1%）在EHT中诊断为MAU。较高的体重指数（BMI），高血压持续时间较长，和更高的严重程度与MAU相关。此外，MAU组的肌酐水平比对照组多近10％（69.5±18.7µmol/Lvs.64.8±12.5µmol/L,P=0.004)。PA也增加（15.5，9.7-20.6ng/dL与12.3,9.0-17.3ng/dL,P=0.024）和UA（419.8±105.6µmol/L与375.1±89.5µmol/L,与对照组相比，MAU组的P<0.001）。几个变量与MAU相关，包括中央舒张压(CDBP)(OR=1.017,95%CI:1.002-1.032,P=0.027),PA(OR=1.043,95%CI:1.009-1.078,P=0.012)和UA(OR=1.005,95%CI:1.002-1.008,P<0.001)。对于MAU预测，CDBP时曲线下面积(AUC)为0.709(95%CI:0.662-0.753,P<0.001),PA,和UA结合使用，截止值的最优概率为0.337。
结论：我们发现CDBP，PA,UA,用于MAU预测，可能与EHT期间的发展有关。
