The role of urinary albumin-to-creatinine ratio as a biomarker to predict stroke: A meta-analysis and systemic review

被引:9
作者
Li, Min [1 ]
Cheng, Aichun [2 ]
Sun, Jingkun [3 ]
Fan, Chunqiu [1 ]
Meng, Ran [1 ]
机构
[1] Capital Med Univ, Dept Neurol, Xuanwu Hosp, 45 Changchun Rd, Beijing 100053, Peoples R China
[2] Capital Med Univ, Dept Neurol, Beijing Tiantan Hosp, Beijing, Peoples R China
[3] Beijing Fengtai Youanmen Hosp, Dept Neurol, Beijing, Peoples R China
关键词
Biomarker; meta-analysis; stroke; systemic review; urinary albumin-to-creatinine ratio; KIDNEY-DISEASE; CARDIOVASCULAR EVENTS; HYPERTENSIVE PATIENTS; INCIDENT STROKE; MINOR STROKE; RISK-FACTORS; MICROALBUMINURIA; ASSOCIATION; REDUCTION; OUTCOMES;
D O I
10.4103/bc.bc_64_20
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Albuminuria excretion rate, calculated as urinary albumin-to-creatinine ratio (UACR), is used clinically to evaluate albuminuria. There are different attitudes to whether high UACR predicts higher risk of stroke. The aim of this study was to evaluate the relationship between UACR and stroke. Two investigators independently searched MEDLINE, EMBASE, Cochrane Controlled Trials Register Database, Scopus and Google Scholar from January 1966 through June 2021 were screened. In addition, a manual search was conducted using the bibliographies of original papers and review articles on this topic. Two blinded reviewers abstracted the data independently to a predefined form. Among the 10,939 initially identified studies, 7 studies with 159,302 subjects were finally included. It is demonstrated that UACR predicted an increased risk of stroke using cutoff value of either 0.43 (HR, 2.39; 95% CI: 1.24 - 4.61; P < 0.01), 10 mg/g (HR, 1.60; 95% CI: 1.30 - 1.97; P < 0.01) or 30 mg/g (HR, 1.84; 95% CI: 1.49 - 2.28; P < 0.01). The overall analysis confirmed that high UACR was associated with an increased rate of stroke (HR, 1.81; 95% CI: 1.52 - 2.17; P < 0.01). Furthermore, High UACR predicted higher risk of stroke in local inhabitants (HR, 1.67; 95% CI: 1.17 - 2.37; P = 0.04), adults (HR, 2.21; 95% CI: 2.07 - 2.36; P < 0.01) or elderly adults (HR, 1.96; 95% CI: 1.56 - 2.46; P < 0.01). Whereas, high UACR was unable to predict stroke in patients with either T2DM (HR, 2.25; 95% CI: 0.55 - 9.17; P = 0.26) or hypertension (HR, 0.95; 95% CI: 0.28 - 3.22; P = 0.93). Another subgroup analysis revealed that high UACR was associated with increased risk of ischemic stroke (HR, 1.60; 95% CI: 1.43 - 1.80; P < 0.01), as well as hemorrhagic stroke (HR, 1.76; 95% CI: 1.22 - 1.45; P < 0.01). In conclusion, UACR is associated with an increased risk of hemorrhagic and ischemic stroke. UACR may be used as an indicator to predict stroke in non-diabetic and non-hypertensive subjects.
引用
收藏
页码:139 / 146
页数:8
相关论文
共 50 条
[41]   Lymphocyte-to-Monocyte Ratio as a Prognostic Biomarker for Acute Myocardial Infarction: A Systematic Review and Meta-Analysis [J].
Gu, Hanshuo ;
Lu, Yian ;
Luo, Jiaxin ;
Yuan, Zhaoshun .
INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, 2025, 2025 (01)
[42]   Temporal Patterning of Neurofilament Light as a Blood-Based Biomarker for Stroke: A Systematic Review and Meta-Analysis [J].
Sanchez, Jasmin D. ;
Martirosian, Richard A. ;
Mun, Katherine T. ;
Chong, Davis S. ;
Llorente, Irene Lorenzo ;
Uphaus, Timo ;
Groeschel, Klaus ;
Woelfer, Teresa A. ;
Tiedt, Steffen ;
Hinman, Jason D. ;
DEMDAS Study Grp .
FRONTIERS IN NEUROLOGY, 2022, 13
[43]   Effect of Amlodipine in Stroke and Myocardial infarction: A Systematic Review and Meta-analysis [J].
Iyengar, Shamanna S. ;
Mohan, Jagdish Chander ;
Ray, Saumitra ;
Rao, M. Srinivasa ;
Khan, Mohammed Yunus ;
Patted, Usha Rani H. ;
Gaurav, Kumar .
CARDIOLOGY AND THERAPY, 2021, 10 (02) :429-444
[44]   Circulating brain-derived neurotrophic factor as a potential biomarker in stroke: a systematic review and meta-analysis [J].
Mojtabavi, Helia ;
Shaka, Zoha ;
Momtazmanesh, Sara ;
Ajdari, Atra ;
Rezaei, Nima .
JOURNAL OF TRANSLATIONAL MEDICINE, 2022, 20 (01)
[45]   Interference of urinary albumin-to-creatinine ratio measurement by glycosuria: clinical implications when using SGLT-2 inhibitors [J].
Chapman, Daniel ;
Judge, Parminder K. ;
Sardell, Rebecca J. ;
Staplin, Natalie ;
Arnold, Thomas ;
Zhu, Doreen ;
Ng, Sarah ;
Moffat, Stewart ;
Landray, Martin J. ;
Baigent, Colin ;
Hill, Michael ;
Haynes, Richard ;
Clark, Sarah ;
Herrington, William G. .
KIDNEY INTERNATIONAL, 2023, 103 (04) :787-790
[46]   The Urinary Albumin-to-Creatinine Ratio Is a Potential Predictor of Target Lesion Revascularization After Percutaneous Coronary Intervention With Coronary Stents [J].
Okada, Takuya ;
Yuge, Masaru ;
Kawaguchi, Takeo ;
Hojo, Yukihiro .
INTERNATIONAL HEART JOURNAL, 2014, 55 (05) :409-415
[47]   Urinary albumin-to-creatinine ratio in decompensated liver cirrhosis among elderly Egyptian patients: a single-center experience [J].
Abdelghani, Ahmed ;
Ibrahim, Maha Hosam El-Din ;
Mohamed, Osama Mohamady ;
Rizk, Sobhi Eid ;
Ahmed, Rabab Mahmoud .
EGYPTIAN JOURNAL OF INTERNAL MEDICINE, 2021, 33 (01)
[48]   The relationship between body mass index and stroke: a systemic review and meta-analysis [J].
Xinyu Wang ;
Yanan Huang ;
Yanru Chen ;
Tingting Yang ;
Wenli Su ;
Xiaoli Chen ;
Fanghong Yan ;
Lin Han ;
Yuxia Ma .
Journal of Neurology, 2022, 269 :6279-6289
[49]   Risk of ischemic stroke in patients with systemic sclerosis: A systematic review and meta-analysis [J].
Ungprasert, Patompong ;
Sanguankeo, Anawin ;
Upala, Sikarin .
MODERN RHEUMATOLOGY, 2016, 26 (01) :128-131
[50]   Urinary albumin-to-creatinine ratio in decompensated liver cirrhosis among elderly Egyptian patients: a single-center experience [J].
Ahmed Abdelghani ;
Maha Hosam El-Din Ibrahim ;
Osama Mohamady Mohamed ;
Sobhi Eid Rizk ;
Rabab Mahmoud Ahmed .
The Egyptian Journal of Internal Medicine, 2021, 33