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Underestimation of urinary albumin to creatinine ratio in morbidly obese subjects due to high urinary creatinine excretion.
- Source :
-
Clinical nutrition (Edinburgh, Scotland) [Clin Nutr] 2012 Apr; Vol. 31 (2), pp. 212-6. Date of Electronic Publication: 2011 Oct 24. - Publication Year :
- 2012
-
Abstract
- Background & Aims: Albuminuria, a chronic kidney and/or cardiovascular disease biomarker, is currently measured as albumin-to-creatinine ratio (ACR). We hypothesize that in severely obese individuals ACR might be abnormally low in spite of relatively high levels of urinary albumin due to increased creatininuria.<br />Methods: One-hundred-eighty-four subjects were divided into tertiles based on their BMI. Fat-free mass (FFM) and fat-mass were assessed by DEXA; 24-h creatinine and albumin excretion, ACR, lipid profile and blood pressure were measured.<br />Results: Twenty-four-hour creatinine highly correlated (R = 0.75) with FFM. Since both creatininuria and albuminuria increased with the BMI, being the increase in creatininuria preponderant in subjects with BMI>35, their ratio (AC-ratio) did not change significantly from that of subjects in the lower BMI tertile. ACR only correlated with the systolic blood pressure, while both albuminuria and cretininuria correlated (P = 0.01) with the absolute 10-year CHD risk. In subjects with BMI>35, 100 mg of albumin excreted with urine increased the CHD risk of 2%.<br />Conclusions: Albumin-to-creatinine ratio is underestimated in severely obese individuals as a consequence of the large creatininuria, which is proportional to the increased FFM. Therefore, at least in this population 24-h albuminuria should be more reliable than ACR.<br /> (Copyright © 2011 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)
- Subjects :
- Adult
Biomarkers urine
Blood Glucose analysis
Blood Pressure
Body Composition
Body Mass Index
Cardiovascular Diseases physiopathology
Cross-Sectional Studies
Female
Humans
Male
Morbidity
Obesity physiopathology
Risk Factors
Specimen Handling
Albumins analysis
Albuminuria urine
Creatinine urine
Obesity urine
Subjects
Details
- Language :
- English
- ISSN :
- 1532-1983
- Volume :
- 31
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Clinical nutrition (Edinburgh, Scotland)
- Publication Type :
- Academic Journal
- Accession number :
- 22030400
- Full Text :
- https://doi.org/10.1016/j.clnu.2011.10.007