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The Association of Urine Microalbumin and Pulse Pressure in Korean Adults

한국 성인에서 뇨 중 Microalbumin과 맥압의 관련성

  • Gee, Mee Young (Department of Nursing, Christian College of Nursing) ;
  • Yoon, Hyun (Department of Biomedical Laboratory Science, Hanlyo University)
  • 기미영 (광주기독간호대학교 간호학과) ;
  • 윤현 (한려대학교 임상병리학과)
  • Received : 2016.07.20
  • Accepted : 2016.08.25
  • Published : 2016.09.30

Abstract

The aim of this study was to assess the association between microalbumin and pulse pressure (PP) in Korean adults. The study subjects were Korean adults 20 years or older (n=4,948) who participated in the Korea National Health and Nutrition Examination Survey 2012. The urine microalbumin level ($M{\pm}SE$) was significantly higher (p=0.047) in the high PP group (PP>60.0 mmHg) [$33.02{\pm}4.93{\mu}g/mL$ (95% confidence interval (CI), 23.37~42.68)] than the normal PP group ($PP{\leq}60.0mmHg$) [$22.57{\pm}1.63{\mu}g/mL$ (95% CI, 19.36~25.77)], after adjusting for age, gender, smoking, drinking, regular exercising, WM, BMI, TC, TG, HDL-C, FBG, BUN, creatinine, and urine creatinine. In conclusion, pulse pressure was associated with the microalbumin level in Korean adults.

본 연구는 국가자료인 2012년도 국민건강영양조사 자료를 이용하여 20세 이상 성인(n=4,948)에서 뇨 중 microalbumin과 맥압(Pulse pressure, PP)의 관련성을 평가하고자 실시하였다. 연구결과에서 연령, 성별, 흡연습관, 음주습관, 운동습관, WM, BMI, TC, TG, HDL-C, FBG, BUN, creatinine, 및 요 중 creatinine 등을 보정하였을 때, 뇨 중 microalbumin평균값에서, High PP (PP>60.0 mmHg) [$33.02{\pm}4.93{\mu}g/mL$ (95% confidence interval (CI), 23.37~42.68)]가 Normal PP ($PP{\leq}60.0mmHg$) [$22.57{\pm}1.63{\mu}g/mL$ (95% CI, 19.36~25.77)]에 비하여 유의하게 높았다(p=0.047). 결론적으로 대한민국 성인에서 PP의 증가는 뇨 중 microalbumin의 증가와 유의한 관련성이 있었다.

Keywords

References

  1. Svendsen PA, Oxenboll B, Christiansen JS. Microalbuminuria in diabetic patients - a longitudinal study. Acta Endocrinol Suppl (Copenhagen). 1981;242:53-54.
  2. Viberti G, Pickup JC, Bilous RW, Keen H, Mackintosh D. Correction of exercise-induced microalbuminuria in insulin-dependent diabetics after 3 weeks of subcutaneous insulin infusion. Diabetes. 1981;30:818-823. https://doi.org/10.2337/diab.30.10.818
  3. Viberti GC, Jarrett RJ, Mahmud U, Hill RD, Argyropoulos A, Keen H. Microalbuminuria as a predictor of clinical nephropathy in insulin-dependent diabetes mellitus. Lancet. 1982;1:1430-1432.
  4. Benetos A, Rudnichi A, Safar M, Guize L. Pulse pressure and cardiovascular mortality in normotensive and hypertensive subjects. Hypertension. 1998;32:560-564. https://doi.org/10.1161/01.HYP.32.3.560
  5. Lee JL, Kwon SK, Kim SH. Association among C-reactive protein, pulse pressure and ischemic heart disease in patients with continuous ambulatory peritoneal dialysis. Korean J nephrol. 2003;22:102-108.
  6. Chae CU, Pfeffer MA, Glynn RJ. Increased pulse pressure and risk of heart failure in the elderly. JAMA. 1999;28:634-639.
  7. Vaccarino V, Holford TR, Krumholz HM. Pulse pressure and risk for myocardial infarction and heart failure in the elderly. JACC. 2000;36:130-138. https://doi.org/10.1016/S0735-1097(00)00687-2
  8. Arulkumaran N, Diwakar R, Tahir Z, Mohamed M, Kaski JC, Banerjee D. Pulse pressure and progression of chronic kidney disease. J Nephrol. 2010;23:189-193.
  9. Yasuno S, Ueshima K, Oba K, Fujimoto A, Hirata M, Ogihara T, et al. Is pulse pressure a predictor of new-onset diabetes in high-risk hypertensive patients?: a subanalysis of the Candesartan Antihypertensive Survival Evaluation in Japan (CASE-J) trial. Diabetes Care. 2010;33:1122-1127. https://doi.org/10.2337/dc09-1447
  10. Narkiewicz K. Obesity and hypertension-the issue is more complex than we thought. Nephrol Dial Transplant. 2006;21:264-267. https://doi.org/10.1093/ndt/gfi290
  11. Safar ME. Pulse pressure. arterial stiffness. and microvessels. Hypertension. 2004;44:121-122. https://doi.org/10.1161/01.HYP.0000135448.73199.75
  12. Gasowski J, Fagard RH, Staessen JA, Grodzicki T, Pocock S, Boutitie F, et al. Pulse blood pressure component as predictor of mortality in hypertension: a meta-analysis of clinical trial control groups. J Hypertension. 2002;20:145-151. https://doi.org/10.1097/00004872-200201000-00021
  13. Sesso HD, Stampfer MJ, Rosner B, Hennekens CH, Gaziano JM, Manson JE, et al. Systolic and diastolic blood pressure, pulse pressure, and mean arterial pressure as predictors of cardiovascular disease risk in Men. Hypertension. 2000;36:801-807. https://doi.org/10.1161/01.HYP.36.5.801
  14. Berne RM, Levy MN. Cardiovascular Physiology. 6 th ed. Saint Louis: Mosby; 1992. p113-144.
  15. Safar ME. Pulse pressure, arterial stiffness, and cardiovascular risk. Curr Opin Cardiol. 2000;15:258-263. https://doi.org/10.1097/00001573-200007000-00009
  16. Franklin SS, Khan SA, Wong ND, Larson MG, Levy D. Is pulse pressure useful in predicting risk for coronary heart disease? The framingham heart study. Circulation. 1999;100:354-360. https://doi.org/10.1161/01.CIR.100.4.354
  17. Staessen JA, Gasowski J, Wang JG, Thijs L, Hond ED, Boissel JP. Risks of untreated and treated isolated systolic hypertension in the elderly: meta-analysis of outcome trials. Lancet. 2000;355:865-872. https://doi.org/10.1016/S0140-6736(99)07330-4
  18. Erdmann E. Microalbuminuria as a marker of cardiovascular risk in patients with type 2 diabetes. Int J Cardiol. 2006;107:147-153. https://doi.org/10.1016/j.ijcard.2005.03.053
  19. Raymond OE, Rita AD, Robert S, Mori JK. Relation of reduction in urinary albumin excretion to ten-year cardiovascular mortality in patients with type 2 diabetes and systemic hypertension. Am J Cardiol. 2012;109;1743-1748. https://doi.org/10.1016/j.amjcard.2012.02.020
  20. Yudkin JS, Jackson CA. Microalbuminuria as predictor of vascular disease in non-diabetic subjects. Lancet. 1988;2:530-533.
  21. Pedrinelli R, Dell'Omo G, Penno G, Bandinelli S, Bertini A, Di Bello V, et al. Microalbuminuria and pulse pressure in hypertensive and atherosclerotic men. Hypertension. 2000;35:48-54. https://doi.org/10.1161/01.HYP.35.1.48
  22. Cirillo M, Stellato D, Laurenzi M, Panarelli W, Zanchetti A, De Santo NG. Pulse pressure and isolated systolic hypertension: association with microalbuminuria. The GUBBIO Study Collaborative Research Group. Kidney Int. 2000;58:1211-1218. https://doi.org/10.1046/j.1523-1755.2000.00276.x
  23. Park SY, Yoon H, Oh HJ. The association of metabolic syndrome, metabolic syndrome score and pulse pressure in Korean adults: Korea National Health and Nutrition Survey, 2012. J Korea Acad Industr Coop Soc. 2015;9:5660-5667.
  24. Parving HH, Persson F, Rossing P. Microalbuminuria: a parameter that has changed diabetes care. Diabetes Res Clin Pract. 2015;107:1-8. https://doi.org/10.1016/j.diabres.2014.10.014

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