Urinary albumin excretion and prevalence of microalbuminuria in a general Chinese population: a cross-sectional study

Liuxia Yan, Jixiang Ma, Xiaolei Guo, Junli Tang, Jiyu Zhang, Zilong Lu, Huicheng Wang, Xiaoning Cai, Linhong Wang, Liuxia Yan, Jixiang Ma, Xiaolei Guo, Junli Tang, Jiyu Zhang, Zilong Lu, Huicheng Wang, Xiaoning Cai, Linhong Wang

Abstract

Background: Microalbuminuria has been shown to be a risk factor for cardiovascular and renal disease in patients with hypertension and diabetes as well as in the general population. Urinary albumin excretion over 24 h is considered a 'gold standard' to detect microalbuminuria. Few studies have used 24-h urinary albumin excretion to analyze the prevalence of and related factors for microalbuminuira in a general Chinese population.

Methods: This study included 1980 adults aged 18-69 years from the Shandong-Ministry of Health Action on Salt and Hypertension (SMASH) Project 2011 survey. Blood pressure, height, weight and waist circumference were measured, and a venous blood and timed 24-h urine samples were collected from each participant. Linear and logistic regression analyses were used to test associations between established cardiovascular risk factors and microalbuminuria.

Results: The median (25th-75th percentile) of 24-h urinary albumin excretion was 6.1 mg/d (4.5-8.7 mg/d) for all adults, 6.0 mg/d (4.4-8.5 mg/d) for men and 6.2 mg/d (4.6-8.9 mg/d) for women. The overall prevalence of microalbuminuria was 4.1% (95% confidence interval [CI]: 3.2-5.0%), 3.7% (95% CI: 2.9-4.5%) for men and 4.6% (95% CI: 3.7-5.5%) for women. Microalbuminuria was present in 8.1% (95% CI: 6.9-9.3%) of individuals with hypertension, 11.4% (95% CI: 10.0-12.8%) of those with diabetes and 15.6% (95% CI: 14.0-17.2%) of those with both. Multiple logistic regression analysis indicated that systolic blood pressure (odds ratio [OR] 1.02; 95% CI: 1.01-1.03) and fasting blood glucose (OR 1.19; 95% CI: 1.05-1.35) were the independent risk factors for microalbuminuria.

Conclusions: Adults in the general population of Shandong Province have a moderate prevalence of microalbuminuria. Those with hypertension and diabetes are at high risk of having microalbuminuria, suggesting the need for screening and early intervention for microalbuminuria among these individuals.

Figures

Figure 1
Figure 1
Unadjusted prevalence of microalbuminuria (%, 95% CI) by duration of hypertension.
Figure 2
Figure 2
Unadjusted prevalence of microalbuminuria (%) by SBP and DBP levels in the participants not treated with anti-hypertensive drugs. a. Unadjusted prevalence of microalbuminuria by SBP level (<110 mmHg, 110-119 mmHg, 120-129 mmHg, 130–139 mmHg, ≥140 mmHg) in participants not treated with anti-hypertensive drugs. The rates of MAU (%, 95% CI) in these groups were 2.6% (95% CI: 1.9–3.3%), 3.1% (95% CI: 2.3–3.9%), 2.5% (95% CI: 1.8–3.2%), 6.2% (95% CI: 5.1–7.3%), 6.3% (95% CI: 5.2–7.4%). b. Unadjusted prevalence of microalbuminuria by DBP level (DBP < 80 mmHg, 80-89 mmHg, 90-99 mmHg, ≥100 mmHg) in the participants not treated with anti-hypertensive drugs. The rates (%, 95% CI) of MAU in these groups were 2.3% (95% CI: 1.6–3.0%), 4.3% (95% CI: 3.4–5.2%), 6.7% (95% CI: 5.6–7.8%), 10.1% (95% CI: 8.8–11.4%).
Figure 3
Figure 3
Unadjusted prevalence of microalbuminuria (%, 95% CI) by number of cardiovascular disease risk factors, including hypertension, diabetes, dyslipidaemia and obesity.

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