| Retinal arteriolar caliber and urine albumin excretion: the Multi-Ethnic Study of Atherosclerosis. | |
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MedLine Citation:
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PMID: 21398363 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: Changes in retinal microvascular caliber, which occur prior to onset of retinopathy, may indicate presence of kidney damage. METHODS: This study examined the association between retinal arteriolar [central retinal artery equivalent (CRAE)] and venular caliber [central retinal venule equivalent (CRVE)] and presence of albuminuria (micro- or macroalbuminuria) among participants of the Multi-Ethnic Study of Atherosclerosis (MESA), a cohort of adults aged 45-84 years without baseline clinical cardiovascular disease. During the second MESA exam, digital fundus photography was completed in 5897 participants who provided spot urine specimens. Albuminuria was defined by spot urine albumin/creatinine ratios ≥30 mg/g. Multivariable adjusted odds of albuminuria by quintiles of CRAE and CRVE were determined using logistic regression. Analyses were repeated after stratifying by presence of type 2 diabetes. RESULTS: Albuminuria was noted in 11.5% (n = 675) and included 584 subjects with microalbuminuria and 91 with macroalbuminuria. A significant U-shaped pattern was seen with higher prevalence of albuminuria across quintile extremes in CRAE (15.7, 8.8 and 10.6% in CRAE Quintiles 1, 3 and 5, respectively; P <0.0001). After adjustment for covariates, both narrower CRAE [odds ratios (OR) 1.55; 95% confidence interval (CI) 1.17-2.04, Quintile 1 versus 3) and wider CRAE (OR 1.44; 95% CI 1.07-1.93, Quintile 5 versus 3) were significantly associated with albuminuria. Associations appeared substantially stronger in adults with than without type 2 diabetes but the interaction term for diabetes and CRAE on presence of albuminuria did not meet statistical significance (P = 0.3). No association was noted between CRVE quintiles and albuminuria. CONCLUSIONS: Albuminuria is associated with narrower and wider arteriolar caliber. Future studies should determine whether variation in arteriolar caliber predicts incident albuminuria and whether associations are mediated by hypertension and diabetes. Such information could further clarify early microvascular processes in the pathogenesis of kidney disease. |
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Authors:
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Stella Awua-Larbi; Tien Y Wong; Mary Frances Cotch; Ramon Durazo-Arvizu; David R Jacobs; Barbara E K Klein; Ronald Klein; Joao Lima; Kiang Liu; Holly Kramer |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-3-11 |
Journal Detail:
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Title: Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association Volume: - ISSN: 1460-2385 ISO Abbreviation: - Publication Date: 2011 Mar |
Date Detail:
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Created Date: 2011-3-14 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8706402 Medline TA: Nephrol Dial Transplant Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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1Northwestern University Feinberg School of Medicine, Chicago, IL, USA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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