Lifestyle and Metabolic Health, Low-Grade to Clinically Elevated Albuminuria, and Cardiovascular-Renal Diseases.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Ding Yi, Cao Qiuyu, Wu Xianglin, Jiang Youjin, Li Xiaoran, Xu Yu, Xu Min, Wang Tiange, Chen Yuhong, Zhao Zhiyun, Zheng Jie, Wang Shuangyuan, Lin Hong, Gu Xuejiang, Yan Li, Zhang Miao, Gao Zhengnan, Chen Lulu, Zeng Tianshu, Hu Ruying, Ye Zhen, Yu Xuefeng, Chen Gang, Su Qing, Mu Yiming, Tang Xulei, Wan Qin, Wang Guixia, Qin Guijun, Luo Zuojie, Qin Yingfen, Chen Li, Hou Xinguo, Huo Yanan, Li Qiang, Qiao Hong, Zhang Yinfei, Liu Chao, Wang Youmin, Wu Shengli, Yang Tao, Deng Huacong, Zhao Jiajun, Wang Weiqing, Ning Guang, Lu Jieli, Li Mian, Bi Yufang
Аннотация
OBJECTIVES: The authors aimed to investigate the differential roles of lifestyle/metabolic factors in the association of fine-categorized and continuously measured urinary albumin-to-creatinine ratio (UACR) levels with cardiorenal outcomes.
METHODS: A total of 82,509 participants from the China Cardiometabolic Disease and Cancer Cohort (4C) Study were included, with a median follow-up of 3.0 years. Outcomes included incident cardiovascular disease (CVD), incident CKD, their composite, along with surrogate markers. Lifestyle factors included tobacco use, alcohol use, diet, physical activity and sleep. Metabolic factors included diabetes, hypertension, abdominal obesity, and elevated low-density lipoprotein cholesterol. Cox proportional hazard models were used to calculate hazard ratios.
RESULTS: Compared to the lowest UACR, participants with mildly elevated UACR (≥10 to <30 mg/g) had a 39% higher risk of composite cardiorenal outcomes (multivariable-adjusted HR: 1.39, 95% CI: 1.29-1.50), whereas those with clinically elevated UACR (≥30 mg/g) had over double the risk (HR: 2.29, 95% CI: 2.12-2.47). A nonlinear J-shaped association was observed between continuous UACR and cardiorenal outcomes (Pnonlinearity = 0.0009), with UACR ≥10 mg/g already conferring risks, a pattern also reflected by the deterioration of PREVENT score and estimated glomerular filtration rate. Optimal lifestyle and metabolic status generally attenuated CVD risk related to low-grade albuminuria, while improvement of the latter additionally decreased CVD and cardiorenal risk, even in clinically elevated albuminuria (additive Pinteraction <0.0001). Hypertension showed the largest relative contribution to cardiorenal risk, particularly in UACR <30 mg/g.
CONCLUSIONS: Our findings highlighted low-grade albuminuria as a key preventive window for cardiorenal outcomes requiring both aspects of modifiable risk factors, and the cardiovascular benefits of metabolic improvement in established albuminuria.