Association between Serum C-reactive Protein Levels and Microalbuminuria: A Population-Based Cross-Sectional Study in Northern Iwate, Japan

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  • NAKAMURA Motoyuki
    Second Department of Internal Medicine, Iwate Medical University School of Medicine
  • ONODA Toshiyuki
    Hygiene and the Preventive Medicine, Iwate Medical University School of Medicine
  • ITAI Kazuyoshi
    Hygiene and the Preventive Medicine, Iwate Medical University School of Medicine
  • OHSAWA Masaki
    Hygiene and the Preventive Medicine, Iwate Medical University School of Medicine
  • SATOU Kenyu
    Second Department of Internal Medicine, Iwate Medical University School of Medicine
  • SAKAI Toshiaki
    Second Department of Internal Medicine, Iwate Medical University School of Medicine
  • SEGAWA Toshie
    Second Department of Internal Medicine, Iwate Medical University School of Medicine
  • SASAKI Junko
    Iwate Health Service Association
  • TONARI Yoko
    Iwate Health Service Association
  • HIRAMORI Katsuhiko
    Second Department of Internal Medicine, Iwate Medical University School of Medicine
  • OKAYAMA Akira
    Hygiene and the Preventive Medicine, Iwate Medical University School of Medicine

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  Objective  The presence of microalbuminuria is a renal marker of vascular endothelial damage, and is an independent and strong predictor of increased risk for cardiovascular mortality and morbidity. Elevated circulating C-reactive protein (CRP) levels have recently been reported to be a novel cardiovascular risk factor, and it has been suggested that this acute-phase protein impairs vascular endothelial function. The aim of the present study was to determine whether serum CRP level is a dependent or an independent risk factor of microalbuminuria in the general population.<br>  Methods  Subjects of this cross-sectional study were apparently healthy individuals drawn from the general Japanese population (mean age, 62; men, 2, 236; women, 4, 217). Serum CRP levels were determined using a highly sensitive kit and urine albumin-creatinine ratio (UACR) was calculated using a single urine sample. Multivariate logistic regression analysis was used to determine which risk factors (ie, age, hypertension, diabetes, obesity, hypercholesterolemia, smoking, and CRP) might predict the presence of microalbuminuria.<br>  Results  In addition to classical cardiovascular risk factors such as age, hypertension, diabetes and obesity, serum CRP levels are also significantly correlated with microalbuminuria in men (odds ratio=1.42, 95% CI=1.13-1.79; p<0.01) and women (odds ratio=1.25, 95% CI=1.05-1.49; p<0.01). When subjects with diabetes were excluded from the analysis, serum CRP levels continued to be a significant predictor for microalbuminuria (odds ratio=1.35, 95% CI=1.06-1.73; p<0.05 for men: odds ratio=1.23, 95% CI=1.03-1.47; p<0.05 for women).<br>  Conclusions  The present study has shown that low-grade inflammation as represented by high sensitivity CRP levels may be significantly related to the presence of microalbuminuria. This suggests that microalbuminuria may be a useful marker representing systemic low-grade inflammation as well as being an established cardiovascular risk factor in apparently healthy individuals.

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  • Internal Medicine

    Internal Medicine 43 (10), 919-925, 2004

    一般社団法人 日本内科学会

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