All Components of Metabolic Syndrome Are Associated with Microalbuminuria in a Chinese Population.

Yi-Yen Lee,Jih-Chang Chen,Yi-Ming Weng,Chung-Hsun Chuang,Chih-Kai Yang,Wen-Cheng Li,Wei Yu,Yan Li

doi:10.1371/journal.pone.0157303

Abstract

Background and AimAlbuminuria is a well-known predictor of poor renal and cardiovascular outcomes and associated with increased risk of all-cause mortality. The study aimed to evaluate the associations between metabolic characteristics and the presence of albuminuria.MethodsThis cross-sectional study included 18,384 adult Chinese who participated in health examinations during 2013–2014. Differences in clinical characteristics were compared for microalbuminuria (MAU) and albuminuria, and between genders. Potential risk factors associated with the risk of developing MAU and albuminuria were analyzed using univariate logistic regression. Multiple logistic regression was applied to further identify the independent associations between different levels of risk factors and the presence of MAU and albuminuria. The area under the ROC curve (AUC) was used to determine the discriminatory ability of metabolic risk factors in detecting albuminuria.ResultsThere were significant gender differences in clinical characteristics according to albuminuria status. Risk for the presence of albuminuria was significantly associated with age, male gender, waist circumference (WC), waist-to-height ratio (WHtR), hypertension, fasting plasma glucose (FPG), and triglycerides to high-density lipoprotein cholesterol ratio (TG/HDL-C) in univariate logistic regression. Multiple logistic regression analysis indicated that the factors significantly associated with the presence of MAU were WC > 90cm, WHtR at 0.6–0.7, hypertension, FPG > 6.1 mmole/L, and TG/HDL-C ratio > 1.6. The optimal cutoffs for risk factors of metabolic syndrome (MetS) to predict albuminuria in males and females were: WC, 90.8 vs. 80.0 cm; WHtR, 0.53 vs. 0.52; MAP, 97.9 vs. 91.9 mmHg; FPG, 5.40 vs. 5.28 mmole/L; and TG/HDL-C, 1.13 vs. 1.08.ConclusionMetS and all its components were associated with the presence of MAU in a health check-up population in China. Gender specific and optimal cutoffs for MetS components associated with the presence of MAU were determined.

Highlights

Urinary albumin excretion is a predictor of mortality from all causes in the general population [1], and can be categorized into three stages: normoalbuminuria (300 mg/24 h)
Risk for the presence of albuminuria was significantly associated with age, male gender, waist circumference (WC), waist-to-height ratio (WHtR), hypertension, fasting plasma glucose (FPG), and triglycerides to high-density lipoprotein cholesterol ratio (TG/ HDL-C) in univariate logistic regression
Multiple logistic regression analysis indicated that the factors significantly associated with the presence of MAU were WC > 90cm, WHtR at 0.6–0.7, hypertension, FPG > 6.1 mmole/L, and TG/HDL-C ratio > 1.6

Summary

Introduction

Urinary albumin excretion is a predictor of mortality from all causes in the general population [1], and can be categorized into three stages: normoalbuminuria (300 mg/24 h). Emerging evidence indicates that microalbuminuria (MAU) is significantly and independently associated with risk for allcause mortality, cardiovascular disease (CVD), chronic kidney diseases (CKD), and progression of end-stage renal disease (ESRD) [2,3,4,5]. In the Third National Health and Nutrition Examination Survey (NHANES III), MAU was associated with MetS, and mainly with the fasting plasma glucose and blood pressure [12]. These observations enabled the published guidelines to include MAU as screening criteria for diabetic kidney disease [18]. The study aimed to evaluate the associations between metabolic characteristics and the presence of albuminuria

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Discussion

Conclusion