TY - JOUR
T1 - Urinary albumin to creatinine ratio as potential biomarker for cerebral microvascular disease
AU - Strickland, Amanda L.
AU - Rossetti, Heidi
AU - Peshock, Ronald M
AU - Weiner, Myron F.
AU - Nakonezny, Paul A
AU - McColl, Roderick W
AU - Hulsey, Keith Mcleod
AU - Das, Sandeep R
AU - King, Kevin S.
PY - 2014/8
Y1 - 2014/8
N2 - Elevated urinary albumin to creatinine ratio (ACR) and white matter hyperintensity (WMH) volume seen on brain MRI are measures of microvascular disease which may have shared susceptibility to metabolic and vascular insults. We hypothesized that elevated ACR may be useful as inexpensive biomarker to predict presence of cerebral microvascular disease. We assessed the association between ACR at study entry and subsequent WMH volume. We evaluated pulse pressure, mean arterial pressure, hypertension duration, waist circumference, fasting glucose, glomerular filtration rate (GFR) and C-reactive protein (CRP) as potential mediators and diabetes as a moderator of the association between ACR and WMH. Data were collected at study entry and at follow-up approximately 7 years later in a multiethnic population sample of 1281 participants (mean age=51, SD=9.5) from Dallas County. Overall, ACR differences were only marginally (p= 0.05) associated with subsequent WMH. In mediator analysis, however, ACR differences related specifically to arterial pulsatility(β=0. 010, bootstrap 95% Confidence Interval (CI): 0.002 to 0.021) and waist circumference (β= -0.004, bootstrap 95% CI: -0.011 to -0.001) were significantly associated with WMH. ACR differences related to serum glucose and CRP were not associated with WMH. ACR evaluated at the same time as WMH had a higher level of significance (p< 0.001) indicating greater utility in predicting current cerebrovascular insults.
AB - Elevated urinary albumin to creatinine ratio (ACR) and white matter hyperintensity (WMH) volume seen on brain MRI are measures of microvascular disease which may have shared susceptibility to metabolic and vascular insults. We hypothesized that elevated ACR may be useful as inexpensive biomarker to predict presence of cerebral microvascular disease. We assessed the association between ACR at study entry and subsequent WMH volume. We evaluated pulse pressure, mean arterial pressure, hypertension duration, waist circumference, fasting glucose, glomerular filtration rate (GFR) and C-reactive protein (CRP) as potential mediators and diabetes as a moderator of the association between ACR and WMH. Data were collected at study entry and at follow-up approximately 7 years later in a multiethnic population sample of 1281 participants (mean age=51, SD=9.5) from Dallas County. Overall, ACR differences were only marginally (p= 0.05) associated with subsequent WMH. In mediator analysis, however, ACR differences related specifically to arterial pulsatility(β=0. 010, bootstrap 95% Confidence Interval (CI): 0.002 to 0.021) and waist circumference (β= -0.004, bootstrap 95% CI: -0.011 to -0.001) were significantly associated with WMH. ACR differences related to serum glucose and CRP were not associated with WMH. ACR evaluated at the same time as WMH had a higher level of significance (p< 0.001) indicating greater utility in predicting current cerebrovascular insults.
KW - Arterial pulsatility
KW - Epidemiology
KW - Glucose handling
KW - Inflammation
KW - Magnetic resonance imaging
KW - Microvascular disease
KW - Waist circumference
KW - White matter disease / hyperintensities
UR - http://www.scopus.com/inward/record.url?scp=84906854178&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84906854178&partnerID=8YFLogxK
U2 - 10.2174/1567202611666140530130327
DO - 10.2174/1567202611666140530130327
M3 - Article
C2 - 24875487
AN - SCOPUS:84906854178
SN - 1567-2026
VL - 11
SP - 242
EP - 247
JO - Current Neurovascular Research
JF - Current Neurovascular Research
IS - 3
ER -