Body mass index (BMI) is associated with microalbuminuria in Chinese hypertensive patients.

Xinyu Liu,Bin Li,Yongqiang Li,Xiaofei Shao,Guanjing Zhang,Youming Chen,Yan Liang,Yu Liu,Harry Holthöfer,Hequn Zou

doi:10.3390/ijerph120201998

Abstract

There is no general consensus on possible factors associated with microalbuminuria in hypertensive patients nor any reported study about this issue in Chinese patients. To examine this issues, 944 hypertensive patients were enrolled in a study based on a cross-sectional survey conducted in Southern China. Multivariate regression analyses were performed to identify the factors related with the presence of microalbuminuria and urinary excretion of albumin. The prevalence of microalbuminuria in hypertensive and non-diabetic hypertensive patients were 17.16% and 15.25%, respectively. Body mass index (BMI), but not waist circumference (WC), were independently associated with microalbuminuria and the values of urinary albumin to creatinine ratio (ACR) based on multiple regression analyses, even after excluding diabetic patients and patients taking inhibitors of the renin-angiotensin system from the analyses. Furthermore, patients with obesity (BMI ≥28) had higher levels of ACR, compared with those with normal weight (BMI <24 kg/m2) and overweight (24 kg/m2≤ BMI < 28). In conclusion, BMI, as a modifiable factor, is closely associated with microalbuminuria among Chinese hypertensive patients, which may provide a basis for future development of intervention approaches for these patients.

Highlights

Microalbuminuria refers to a clinical abnormality with a moderately increased amount of albumin extracted to the urine, presumably due to glomerular capillary damage [1]
We found that the prevalence rates of microalbuminuria in hypertensive and non-diabetic hypertensive patients were 17.16%
The main purpose of this study was to investigate the potential risk factors associated with microalbuminuria in hypertensive patients, focusing on body mass index (BMI) and Waist circumference (WC), with the understanding that these are modifiable risk factors

Summary

Introduction

Microalbuminuria refers to a clinical abnormality with a moderately increased amount of albumin extracted to the urine, presumably due to glomerular capillary damage [1]. It is widely accepted that microalbuminuria is associated with a widespread vascular dysfunction and is considered as an indicator of increased cardiovascular risk and all-cause mortality, especially for high-risk populations such as hypertensive patients [2,3]. Several guidelines recommend a regular screening for microalbuminuria in hypertensive patients [4,5]. Intervention measures against the occurrence or progression of this early stage renal injury in hypertensive patients can delay or prevent end-stage kidney disease (ESRD) and severe cardiovascular diseases. Characterization of possible risk factors for the presence of microalbuminuria in hypertensive patients may provide valuable information for clinical intervention. Hypertension is considered the second leading cause of ESRD worldwide, the risk for patients with uncomplicated essential hypertension to develop serious renal injury is relatively low [5]

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