TY - JOUR
T1 - Changes in proteinuria and the risk of myocardial infarction in people with diabetes or pre-diabetes
T2 - A prospective cohort study
AU - Wang, Anxin
AU - Sun, Yang
AU - Liu, Xiaoxue
AU - Su, Zhaoping
AU - Li, Junjuan
AU - Luo, Yanxia
AU - Chen, Shuohua
AU - Wang, Jianli
AU - Li, Xia
AU - Zhao, Zhan
AU - Zhu, Huiping
AU - Wu, Shouling
AU - Guo, Xiuhua
N1 - Publisher Copyright:
© 2017 The Author(s).
PY - 2017/8/15
Y1 - 2017/8/15
N2 - Background: The relationship between changes in proteinuria and myocardial infarction (MI) remains unclear in people with diabetes or pre-diabetes. We aimed to evaluate the predictive value and independent role of changes in proteinuria over a 2-year period in the incidence of MI in people with diabetes or pre-diabetes. Methods: Based on the baseline and 2-year dipstick screening results from the Kailuan prospective cohort study, participants were divided into four categories: no proteinuria, remittent proteinuria, incident proteinuria, and persistent proteinuria. Four multivariable Cox proportional hazard models were built to adjust for the effects of different confounding covariates. Results: Among the 17,625 participants in this study, there were a total of 238 incidents of MI during a median follow-up of 6.69years. After adjusting for demography factors and laboratory indices, the association between persistent proteinuria and MI incidence was maintained (hazard ratio [HR] 2.50, 95% confidence interval [CI] 1.48-4.22). Every decrease of proteinuria from 2006 to 2008 was observed to be responsible for a 21% decline of MI incidence (HR 0.79, 95% CI 0.68-0.90). The interaction between changes in proteinuria and diabetes was confirmed with no effect on MI (P=0.3371). Conclusions: Persistent proteinuria is an independent risk factor for MI incidence in the pre-diabetic and diabetic population. These findings may help clinicians to interpret proteinuria changes in the outpatient setting and provide possible preventive approaches for people with pre-diabetes or diabetes.
AB - Background: The relationship between changes in proteinuria and myocardial infarction (MI) remains unclear in people with diabetes or pre-diabetes. We aimed to evaluate the predictive value and independent role of changes in proteinuria over a 2-year period in the incidence of MI in people with diabetes or pre-diabetes. Methods: Based on the baseline and 2-year dipstick screening results from the Kailuan prospective cohort study, participants were divided into four categories: no proteinuria, remittent proteinuria, incident proteinuria, and persistent proteinuria. Four multivariable Cox proportional hazard models were built to adjust for the effects of different confounding covariates. Results: Among the 17,625 participants in this study, there were a total of 238 incidents of MI during a median follow-up of 6.69years. After adjusting for demography factors and laboratory indices, the association between persistent proteinuria and MI incidence was maintained (hazard ratio [HR] 2.50, 95% confidence interval [CI] 1.48-4.22). Every decrease of proteinuria from 2006 to 2008 was observed to be responsible for a 21% decline of MI incidence (HR 0.79, 95% CI 0.68-0.90). The interaction between changes in proteinuria and diabetes was confirmed with no effect on MI (P=0.3371). Conclusions: Persistent proteinuria is an independent risk factor for MI incidence in the pre-diabetic and diabetic population. These findings may help clinicians to interpret proteinuria changes in the outpatient setting and provide possible preventive approaches for people with pre-diabetes or diabetes.
KW - Diabetes
KW - Myocardial infarction
KW - Pre-diabetes
KW - Proteinuria
UR - http://www.scopus.com/inward/record.url?scp=85027676758&partnerID=8YFLogxK
U2 - 10.1186/s12933-017-0586-7
DO - 10.1186/s12933-017-0586-7
M3 - Article
C2 - 28807011
AN - SCOPUS:85027676758
SN - 1475-2840
VL - 16
JO - Cardiovascular Diabetology
JF - Cardiovascular Diabetology
IS - 1
M1 - 104
ER -