Analysis of test results for determining urine albumin-to-creatinine ratio among health examination population in a hospital

Objective To investigate the prevalence of high urine albumin-to-creatinine ratio (ACR) among health check up population and evaluate the potential predictors for ACR. Methods A cross-sectional study was conducted among health check up population in the Zhongshan Hospital during 2015. Potential participants completed urine ACR test, body mass index (BMI) and blood test. ACR level was divided into two groups according to the K/DOQI recommendation: ACR Group (male: ACR≥17 mg/g; female: ≥25 mg/g) , Normal Group (male: ACR<17 mg/g; female: ACR<25 mg/g). Univariate and multivariate logistic regression models were performed to evaluate the associations of ACR with potential predictors (including age, sex, over-weight or obesity, hypertension, glucose metabolism disorders, hypertriglyceridemia, hypercholesterolemia, high low HDL-C and hyperuricemia) . Result Totally 670 people from the health check up population were screened for ACR test, 54 cases were positive, the prevalence was 8.1%. Age, BMI, waist-to-height ratio, SBP, DBP, blood sugar and uric acid had statistical significance between Normal group and ACR group[Age 47.62±11.29 vs. 53.83±11.93, t=-3.858, P<0.01; BMI (24.05±3.12) kg/m2vs. (24.94±3.49) kg/m2, t=-1.982, P<0.05; waist-to-height ratio 0.51±0.52 vs. 0.53±0.06, Z=-2.146, P<0.05; SBP (mmHg, 1 mmHg=0.133 kPa) 115.31±15.59 vs. 130.91±23.66, t=-4.755, P<0.01; DBP(mmHg) 72.31±9.16 vs. 80.02±9.81, t=-5.897,P<0.01; blood sugar (mmol/L) 4.64±1.20 vs. 5.57±2.77, t=-2.466, P<0.01; uric acid (μmol/L) 362.99±92.80 vs. 397.76±95.62, t=-2.633, P<0.01]. Age, hypertension, glucose metabolism, HDL reduction were risk factors for urinary albumin/creatinine ratio. In the multivariate logistic regression model, hypertension status was found to be associated with ACR positive [odd ratio (OR): 2.843, 95% confidence interval [CI, 1.472-5.493, P<0.01], glucose metabolism disorders (OR, 2.132, 95%CI, 1.042-4.365, P<0.05). As the number of risk factors increases, the rate of positive of ACR showed marked increase, comparing persons with no risk factors to those with four or more risk factors, the OR value rose up to 18.281. Conclusion Hypertension and glucose metabolism disorder are risk factors of chronic renal dysfunction. With the increase of risk factors, the rate of positive of ACR was higher. ACR test is recommended routine screening for people over the age of 50. Key words: Hypertension; Diabetes mellitus; Screening; Risk factor; Albumin-to-creatinine ratio