| 摘要: |
| 目的 探讨上海市外来青壮年建筑工人尿微量白蛋白/肌酐比值（urinary albumin to creatinine ratio，UACR）与血压水平的关联性。方法 采用整群随机抽样法从上海建工集团外来建筑工人中抽取3 195名青壮年（18～50岁）建筑工人，由专业人员进行问卷调查、体格检查和生化指标检测，检测的生化指标包括UACR、肾功能、血尿酸（uric acid，UA）、血糖、血脂等；根据UACR四分位数由低到高将研究对象分为Ⅰ、Ⅱ、Ⅲ、Ⅳ 4组，采用有序多分类logistic回归模型分析UACR与血压分组的关联性。结果 抽样人群中共完成3 112例调查，资料完整率97.4%。正常血压、高血压前期及高血压组的UACR水平[中位数（25%分位数～75%分位数）]分别为0.8（0.6～1.2）、0.9（0.7～1.4）和1.0（0.8～1.7）mg/mmol，高UACR率分别为6.8%、8.0%及15.6%，3组间上述两指标差异均有统计学意义（P<0.05）。根据UACR水平将研究对象分为Ⅰ、Ⅱ、Ⅲ、Ⅳ 4组，在调整年龄等因素后，发现UACR各分组的收缩压分别为（126.8±13.3）、（127.9±14.2）、（129.9±14.4）和（134.2±19.0）mmHg（1 mmHg=0.133 kPa），舒张压分别为（77.6±9.7）、（78.8±9.2）、（79.2±10.4）和（81.8±12.5）mmHg，收缩压和舒张压水平均与UACR呈正相关。有序多分类logistic模型分析发现，在调整年龄、体质指数、总胆固醇及低密度脂蛋白胆固醇等混杂因素后，与UACR Ⅰ组比较，Ⅱ、Ⅲ、Ⅳ组发生高血压前期与高血压的比值比（odds ratio，OR）和95%可信区间（confidence interval，CI）依次为0.98（0.80~1.20）、1.29（1.05~1.58）、1.86（1.52~2.28）。结论 上海外来青壮年建筑工人UACR水平与高血压前期及高血压发生正相关。 |
| 关键词: 成年人 高血压 高血压前期 尿微量白蛋白/肌酐比值 |
| DOI：10.3724/SP.J.1008.2014.00260 |
| 投稿时间：2013-10-20修订日期：2013-11-21 |
| 基金项目:上海市卫生局科研项目（20114288）. |
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| Relationship between urinary albumin-to-creatinine ratio and prehypertension among young migrant builders in Shanghai |
| GUO Ai-zhen1,CEN Jun1*,WEI Li-li1,GU Yi-zheng1,CHANG Wen-jun2 |
(1. Department of Nephrology, Shanghai Jiangong Hospital, Shanghai 200083, China;
2. Department of Epidemiology, Faculty of Tropical Medicine and Public Health, Second Military Medical University, Shanghai 200433, China
*Corresponding author.) |
| Abstract: |
| Objective To explore the relationship between urinary albumin-to-creatinine ratio (UACR) and blood pressure of young migrant builders in Shanghai. Methods A total of 3 195 builders (age ranged from 18 to 50) were selected from migrant builders of Shanghai Construction Group Co., Ltd. by using random cluster sampling method. They were subjected to questionnaire interview, physical examination, and biochemical tests, including UACR, renal function, serum uric acid, serum lipid, and serum glucose. The participants were divided into 4 groups (Ⅰ, Ⅱ, Ⅲ, and Ⅳ)according to the levels of UACR, and the ordinal multinomial logistic regression model was employed to determine the relationship between UACR levels and blood pressure grouping (normal, pre-hypertension, and hypertension). Results Among the 3 195 builders, 3 112 (97.4%) finished interview. The UACR (median [Q1-Q3]) levels and high-UACR ratio for the normal, pre-hypertension and hypertension groups were 0.8 (0.6-1.2) mg/mmol, 0.9 (0.7-1.4) mg/mmol, and 1.0 (0.8-1.7) mg/mmol, and 6.8%, 8.0%, and 15.6%, respectively, with significant differences for both UACR levels and high-UARC ratios (P<0.05) among the 3 blood pressure groups. According to the 25%, 50%, and 75% quartiles of UACR values, builders were classified into 4 groups. After adjustment of the other factors such as age, the average systolic pressures of the Ⅰ, Ⅱ, Ⅲ, and Ⅳ UACR groups were (126.8±13.3), (127.9±14.2), (129.9±14.4 ), and(134.2±19.0) mmHg (1 mmHg=0.133 kPa), and the average diastolic pressures of the 4 groups were (77.6±9.7), (78.8±9.2), (79.2±10.4), and (81.8±12.5) mmHg, respectively. UACR was positively correlated with both the average systolic pressures and diastolic pressures (P<0.05). Logistic regression analysis showed that, after adjusting the factors such as age, body mass index, total cholesterol, and low density lipoprotein cholesterol, the odds ratio (OR) and 95% confidence interval (95%CI) of pre-hypertension and/or hypertension, compared with Ⅰ group, were 0.98 (0.80-1.20), 1.29 (1.05-1.58), and 1.86 (1.52-2.28) for Ⅱ,Ⅲ,and Ⅳ groups, respectively. Conclusion The UACR is positively correlated with pre-hypertension and hypertension among young migrant builders in Shanghai. |
| Key words: adult hypertension pre-hypertension urinary albumin-to-creatinine ratio |
