Study Of Correlation Between Microalbuminuria Levels And Cardiovascular Risk Factors’ Clustering In A Middle-aged And Elderly Population

Objective: To study the correlation between microalbuminuria levels,electrocardiographic left ventricular hypertrophy and cardiovascular diseaserisk factors’clustering in a middle-aged and elderly population.Methods: A total of 12557 middle-aged and elderly people, aged morethan 40 years, were chosen from ten villages in Fengjin town, Jinshan district,Shanghai city. Data on their demography, family history, smoking anddrinking, physical exercise and health was collected using questionnaires.anthropometric parameters and blood pressure were obtained with physicalexamination; fasting blood and morning urine samples were collected formeasurement of biochemical parameters such as blood glucose, creatinine,triglyceride, total cholesterol, low density lipoprotein cholesterol, high densitylipoprotein cholesterol，urine albumin, urine creatinine. Left ventricularhypertrophy was evaluated with the electrocardiogram and its Minnesota andNovacode codes. Cardiovascular risk factors (age, blood lipid, hypertension,diabetes and smoking) were analyzed using Framingham risk scores, and the10-year coronary heart disease risk was computed.Results: (1) UACR (urine albumin/creatinine ratio) was obtained in6442 people and 1341 of them had microalbuminuria (UACR levels30–300μg/mg). UACR levels in the female were much higher than that in themale; UACR levels in the total population or the female population increasedwith age. People with risk factors such as obesity, hypertension, diabetes mellitus or dyslipidemia had higher UACR levels than healthy people. Incomparison with people without risk factors, those with 1, 2, 3 and over 4cardiovascular risk factors had 1.5, 1.4, 2.3 and 4.1 times higher risks (oddratios) of developing microalbuminuria, respectively. (2) Electrocardiographywas performed in 4414 subjects, 509 and 80 of which had MCLVH andNCLVH, respectively. Prevalence of MCLVH increased with age, andprevalence of MCLVH and NCLVH in the male was higher than that in thefemale. MCLVH was independently related to hypertension and smoking.NCLVH was independently related to diabetes. Compared to people withoutcardiovascular risk factors, peoples with three or more cardiovascular riskfactors had 1.6 times higher risk of developing MCLVH. The Framinghamrisk score or 10-year risk of CHD (coronary heart disease) was significantlyhigher in people with ECGLVH than in people without ECGLVH. (3)Microalbuminuria was independently related to age, gender, SBP (systolicblood pressure), DBP (diastolic blood pressure), GLU (blood glucose),NCLVH or MCLVH; MCLVH was independently related to age, gender, SBPor UACR. NCLVH was independently related to gender, GLU or UACR.Those with UACR levels≥24.4μg/mg had 2.3 times higher risk ofdeveloping NCLVH than those with UACR≤8.9μg/mg.Conclusion: (1) Microalbuminuria was independently related tocardiovascular risk factors’clustering, electrocardiographic left ventricularhypertrophy, or Framingham risk scores. (2) Electrocardiographic leftventricular hypertrophy was independently related to clustering ofcardiovascular risk factors.