Julie Lin of Brigham and Women's Hospital) and colleagues found that participants with low urinary albumin-to-creatinine ratio
experienced cognitive decline at a rate 2 to 7 times faster in all cognitive measures than that attributed to aging alone over an average 6 years of follow-up.
Ten biomarkers in 3209 participants attending a routine examination cycle of the Framingham Heart Study: the levels of C-reactive protein, B-type natriuretic peptide, N-terminal pro-atrial natriuretic peptide, aldosterone, renin, fibrinogen, D-dimer, plasminogen-activator inhibitor type 1, and homocysteine; and the urinary albumin-to-creatinine ratio
. During follow-up (median, 7.4 years), 207 participants died and 169 had a first major cardiovascular event.
Fasting levels of 10 biomarkers (C-reactive protein, B-type natriuretic peptide, N-terminal proatrial natriuretic peptide, aldosterone, renin, fibrinogen, D-dimer, plasminogen-activator inhibitor type 1, homocysteine, and the urinary albumin-to-creatinine ratio) were measured.
The model developed to predict risk of death included C-reactive protein, B-type natriuretic peptide, urinary albumin-to-creatinine ratio, homocysteine, and plasma renin; the model for initial cardiovascular event included only B-type natriuretic peptide and urinary albumin-to-creatinine ratio.
Microalbuminuria was defined as a urinary albumin-to-creatinine ratio
of more than 35 in women or more than 25 in men.
"We hypothesized that we would find an association between SDB as defined by the respiratory disturbance index and urinary albumin excretion as defined by the urinary albumin-to-creatinine ratio
," said Dr.
The vast majority of these patients had a modest level, with a urinary albumin-to-creatinine ratio
of less than 30 mg/g.
By week 12 the urinary albumin-to-creatinine ratio
was reduced by 13% in the enalapril 20 mg monotherapy group, compared with 52% in the eplerenone 50 mg plus enalapril 20 mg group and 55% in the eplerenone 100 mg plus enalapril 20 mg group.