The comorbidity of increased arterial stiffness and microalbuminuria in a survey of middle-aged adults in China

Abstract

Background: Increased arterial stiffness (iAS) and microalbuminuria (MAU), which may occur simultaneously or separately in the general population and share similar risk factors, are markers of macro- and microvascular injuries. Our research investigated the comorbidity of iAS and MAU in the middle-aged population and examined the heterogeneous effects of metabolic risk factors on iAS and MAU. Methods: We selected 11,911 individuals aged 45 to 60 years who underwent a health examination at the 3rd Xiangya Hospital between 2010 and 2014. Metabolic syndrome (MetS) was determined according to IDF/NHLBI/AHA-2009 criteria. Multinomial logistic regression was applied to evaluate the influence of MetS, components of MetS and clusters of MetS on the co-occurrence (MAU(+)/iAS(+)) or non-co-occurrence (MAU(+)/iAS(-) and MAU(-)/iAS(+)) of MAU and iAS. Results: Reference group was MAU(-)/iAS(-). A positive effect of MetS on the presence of MAU(+)/iAS(-), MAU(-)/iAS(+), or MAU(+)/iAS(+) is listed in ascending order based on odds ratios (ORs=2.11, 2.41, 4.61, respectively; P<0.05). Compared with MAU(+)/iAS(-), Elevated blood pressure (BP) (OR=1.62 vs. 4.83, P< 0.05), triglycerides(TG) (OR=1.20 vs. 1.37, P< 0.05) were more strongly associated with MAU(-)/iAS(+), whereas fasting blood glucose (FBG) was less associated (OR=1.37 vs. 1.31, P< 0.05). Decreased high-density lipoprotein cholesterol(HDL-c) (OR=1.84, P< 0.01) and elevated waist circumference(WC) (OR=1.28 P< 0.01) were the most strongly associated with MAU(+)/iAS(-). Compared with the individuals without MetS, individuals with the elevated BP, FBG, TG and decreased HDL-c cluster had the greatest likelihood of presenting a MAU(-)/iAS(+) (OR=5.98, P<0.01) and MAU(+)/iAS(+) (OR=13.17, P<0.01), these likelihood was even greater than the cluster with simultaneous alteration in all five MetS components (OR=3.89 and 10.77, respectively, P<0.01), which showed the most strongly association with MAU(+)/iAS(+) (OR=5.22, P<0.01). Conclusion: Based on the heterogeneous influences of MetS-related risk factors on MAU and iAS, these influences could be selectively targeted to identify different types of vascular injuries.