Cause-specific mortality according to urine albumin creatinine ratio in the general population

• Published in: PloS one Vol. 9; no. 3; p. e93212
• Main Authors: Skaaby, Tea, Husemoen, Lise Lotte Nystrup, Ahluwalia, Tarunveer Singh, Rossing, Peter, Jørgensen, Torben, Thuesen, Betina Heinsbæk, Pisinger, Charlotta, Rasmussen, Knud, Linneberg, Allan
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 27.03.2014; Public Library of Science (PLoS)
• Subjects: Adult; Albumin; Albuminuria - epidemiology; Albuminuria - etiology; Albuminuria - mortality; Albuminuria - urine; Analysis; Cardiovascular disease; Cardiovascular diseases; Cardiovascular Diseases - mortality; Cardiovascular Diseases - urine; Cause of Death; Chronic obstructive pulmonary disease; Circulatory system; Continuity (mathematics); Creatinine; Creatinine - urine; Death; Denmark - epidemiology; Diabetes; Diabetes mellitus; Diabetes Mellitus - mortality; Diabetes Mellitus - urine; Digestive system; Disease prevention; Disorders; Female; Follow-Up Studies; Health aspects; Health risks; Hospitals; Humans; Hypertension; Kidney diseases; Male; Medical research; Medicine and Health Sciences; Metabolic disorders; Metabolic syndrome; Middle Aged; Mortality; Population; Population studies; Population Surveillance; Proportional Hazards Models; Registries; Regression analysis; Research and Analysis Methods; Respiratory system; Risk Factors; Significance; Statistical analysis; Statistical methods; Statistical significance; Studies; Systematic review; Type 2 diabetes; Urine; Womens health; Denmark; Aarhus Denmark
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0093212

Urine albumin creatinine ratio, UACR, is positively associated with all-cause mortality, cardiovascular disease and diabetes in observational studies. Whether a high UACR is also associated with other causes of death is unclear. We investigated the association between UACR and cause-specific mortality. We included a total of 9,125 individuals from two population-based studies, Monica10 and Inter99, conducted in 1993-94 and 1999-2001, respectively. Urine albumin creatinine ratio was measured from spot urine samples by standard methods. Information on causes of death was obtained from The Danish Register of Causes of Death until 31 December 2010. There were a total of 920 deaths, and the median follow-up was 11.3 years. Multivariable Cox regression analyses with age as underlying time axis showed statistically significant positive associations between UACR status and risk of all-cause mortality, endocrine nutritional and metabolic diseases, mental and behavioural disorders, diseases of the circulatory system, and diseases of the respiratory system with hazard ratios 1.56, 6.98, 2.34, 2.03, and 1.91, for the fourth UACR compared with the first, respectively. Using UACR as a continuous variable, we also found a statistically significant positive association with risk of death caused by diseases of the digestive system with a hazard ratio of 1.02 per 10 mg/g higher UACR. We found statistically significant positive associations between baseline UACR and death from all-cause mortality, endocrine nutritional and metabolic diseases, and diseases of the circulatory system and possibly mental and behavioural disorders, and diseases of the respiratory and digestive system.