背景/目的:蛋白尿被证明是房颤(AF)的危险因素,可以可逆或持续的形式出现。我们的目的是在全国普通人群的纵向队列研究中,研究蛋白尿状态的变化与房颤风险之间的关系。方法:我们纳入了接受重复健康检查的参与者(n=1,708,103)。通过试纸尿液分析结果确定蛋白尿的存在。结果是房颤的发生(国际疾病分类-10代码:I48)。结果:所有参与者,1,666,111(97.5%),17,659(1.0%),19,696(1.2%),和4637(0.3%),被分为无蛋白尿组,改进,进展,和持久的,分别。在14.5年的中位随访中,发生了41,190例(2.4%)房颤。在多变量分析中,在蛋白尿改善组和蛋白尿持续组,房颤的风险随着初始严重程度更严重而增加(p<0.001).在进一步的成对比较中,与蛋白尿持续组相比,蛋白尿改善组的AF风险相对较低(HR:0.751,95%CI:0.652-0.865,p<0.001).结论:我们的研究表明,房颤的风险可以根据蛋白尿状态的改变而改变。值得注意的是,从蛋白尿中恢复也可以被认为是房颤的一个可改变的危险因素。
Background/Objectives:
Proteinuria is documented as a risk factor for atrial fibrillation (AF) and can manifest in either reversible or continued forms. Our objective was to examine the relationship between the change in status for proteinuria and the risk of AF in a longitudinal cohort study on the general population nationwide. Methods: We included participants (n = 1,708,103) who underwent repetitive health examinations. The presence of
proteinuria was determined by dipstick urinalysis results. The outcome was the occurrence of AF (International Classification of Diseases-10 code: I48). Results: All included participants, 1,666,111 (97.5%), 17,659 (1.0%), 19,696 (1.2%), and 4637 (0.3%), were categorized into groups of proteinuria-free, improved, progressed, and persistent, respectively. During a median follow-up of 14.5 years, 41,190 (2.4%) cases of AF occurred. In the multivariable analysis, the risk of AF was increased as the initial severity was more severe in the proteinuria-improved and
proteinuria-persistent groups (p for trend < 0.001). In a further pairwise comparison, the proteinuria-improved group had a relatively lower risk of AF compared to the
proteinuria-persistent group (HR: 0.751, 95% CI: 0.652-0.865, p < 0.001). Conclusions: Our study showed that the risk of AF can change according to alterations in proteinuria status. Notably, recovering from
proteinuria can also be considered a modifiable risk factor for AF.