Prevalence of microalbuminuria and its associated cardiometabolic risk factors in Korean youth: Data from the Korea National Health and Nutrition Examination Survey

Background Microalbuminuria is a known early predictive factor for renal and cardiovascular diseases, not only for patients with diabetes mellitus or hypertension but also in the general population. However, the prevalence and risk factors associated with microalbuminuria in Korean youth are unknown. Objectives The aims of this study are to evaluate the prevalence of microalbuminuria and the association between microalbuminuria and obesity or cardiometabolic risk factors in Korean children and adolescents without diabetes. Methods This study examines data obtained from the Korea National Health and Nutrition Examination Survey (between 2011 and 2014). It includes a total of 1,976 participants aged between 10 and 19 years (boys 1,128 and girls 848). Microalbuminuria was defined as a urine albumin-to-creatinine ratio (UACR) of ≥ 30 mg/g and < 300 mg/g. Association between microalbuminuria and the risk factors for cardiometabolic diseases including insulin resistance was evaluated. Results The prevalence of microalbuminuria was found to be 3.0% in Korean children and adolescents over this time period. The mean UACR for non-obese youth was significantly greater than that found in obese youth (3.2 ± 0.1 mg/g in the non-obese group vs. 2.1 ± 0.2 mg/g in the obese group; P < 0.001). In multiple logistic regression analysis, microalbuminuria was associated with hyperglycemia (OR 2.62, 95% CI 1.09–6.30) and hemoglobin A1c (OR 3.34, 95% CI 1.09–10.17) in the non-obese group and hypertension (OR 14.10, 95% CI 1.12–177.98) and HbA1c (OR 6.68, 95% CI 1.87–23.95) in the obese group. Conclusions The prevalence of microalbuminuria is not prominent in obese children and adolescents. Our findings demonstrated that the presence of hypertension and hyperglycemia was associated with microalbuminuria. Especially Hemoglobin A1c was associated with microalbuminuria in youths regardless of weight status. Microalbuminuria in pediatric population can be a helpful marker for the risk of cardiovascular disease.

[1]  D. de Zeeuw,et al.  Prevalence and distribution of (micro)albuminuria in toddlers. , 2016, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[2]  H. Kang,et al.  Association between Body Mass Index, Waist Circumference and Prevalence of Microalbuminuria in Korean Adults of Age 30 Years and Older without Diabetes, Hypertension, Renal Failure, or Overt Proteinuria: The 2013 Korean National Health and Nutrition Examination Survey , 2016, Korean journal of family medicine.

[3]  Yu Xu,et al.  Glycated haemoglobin A1c is associated with low-grade albuminuria in Chinese adults , 2015, BMJ Open.

[4]  F. Bacha,et al.  Urine Albumin-to-Creatinine Ratio: A Marker of Early Endothelial Dysfunction in Youth. , 2015, The Journal of clinical endocrinology and metabolism.

[5]  S. Janković,et al.  Risk factors for the development of metabolic syndrome in obese children and adolescents. , 2015, Srpski arhiv za celokupno lekarstvo.

[6]  S. Grundy,et al.  Triglyceride–to–High-Density-Lipoprotein-Cholesterol Ratio Is an Index of Heart Disease Mortality and of Incidence of Type 2 Diabetes Mellitus in Men , 2014, Journal of Investigative Medicine.

[7]  Kyungwon Oh,et al.  Data Resource Profile: The Korea National Health and Nutrition Examination Survey (KNHANES) , 2014, International journal of epidemiology.

[8]  M. Noda,et al.  Adiponectin and visceral fat associate with cardiovascular risk factors , 2014, Obesity.

[9]  W. Ding,et al.  Early markers of obesity-related renal injury in childhood , 2014, Pediatric Nephrology.

[10]  E. Torun,et al.  Determination of early urinary renal injury markers in obese children , 2014, Pediatric Nephrology.

[11]  B. Rhee,et al.  Prevalence of and Factors Associated with Albuminuria in the Korean Adult Population: The 2011 Korea National Health and Nutrition Examination Survey , 2013, PloS one.

[12]  J. Redón,et al.  Prevalence and factors related to urinary albumin excretion in obese youths , 2013, Journal of hypertension.

[13]  Jun-Fen Fu,et al.  Relationship between glycated haemoglobin and subclinical atherosclerosis in obese children and adolescents , 2013, Archives of Disease in Childhood.

[14]  M. Heo,et al.  Waist circumference-to-height ratio predicts adiposity better than body mass index in children and adolescents , 2013, International Journal of Obesity.

[15]  Dong Ho Kim,et al.  Healthy Range of Serum Alanine Aminotransferase and Its Predictive Power for Cardiovascular Risk in Children and Adolescents , 2013, Journal of pediatric gastroenterology and nutrition.

[16]  W. Sheu,et al.  High triglyceride-to-HDL cholesterol ratio associated with albuminuria in type 2 diabetic subjects. , 2013, Journal of diabetes and its complications.

[17]  J. Beijnen,et al.  Limited value of routine microalbuminuria assessment in multi-ethnic obese children , 2013, Pediatric nephrology (Berlin, West).

[18]  R. Kelishadi,et al.  Kidney function in obese adolescents with or without metabolic syndrome in a nationally-representative sample of pediatric population: First report from the Middle East and North Africa: The CASPIAN-III Study: A Case-Control Study , 2013, Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences.

[19]  S. Caprio,et al.  The Triglyceride-to-HDL Cholesterol Ratio , 2011, Diabetes Care.

[20]  S. Caprio,et al.  Association with insulin resistance in obese youths of different ethnic backgrounds , 2011 .

[21]  I. Cataldo,et al.  Implications for kidney disease in obese children and adolescents , 2011, Pediatric Nephrology.

[22]  Y. Yılmaz,et al.  Microalbuminuria in nondiabetic patients with nonalcoholic fatty liver disease: association with liver fibrosis. , 2010, Metabolism: clinical and experimental.

[23]  A. Thanopoulou,et al.  Glycated hemoglobin, diabetes, and cardiovascular risk in nondiabetic adults. , 2010, The New England journal of medicine.

[24]  G. Can,et al.  "Atherogenic index of plasma" (log10 triglyceride/high-density lipoprotein-cholesterol) predicts high blood pressure, diabetes, and vascular events. , 2010, Journal of clinical lipidology.

[25]  A. Sinaiko,et al.  Albuminuria in children , 2009, Current opinion in nephrology and hypertension.

[26]  I. Zineh,et al.  The triglyceride/high-density lipoprotein cholesterol ratio predicts all-cause mortality in women with suspected myocardial ischemia: a report from the Women's Ischemia Syndrome Evaluation (WISE). , 2009, American heart journal.

[27]  Susan L Furth,et al.  New equations to estimate GFR in children with CKD. , 2009, Journal of the American Society of Nephrology : JASN.

[28]  C. McCulloch,et al.  Factors and Microalbuminuria in Adolescents Being Overweight Modifies the Association between Cardiovascular Risk , 2022 .

[29]  Kyungwon Oh,et al.  2007 Korean National Growth Charts: review of developmental process and an outlook , 2008 .

[30]  L. Gilardini,et al.  Metabolic syndrome in obese Caucasian children: prevalence using WHO-derived criteria and association with nontraditional cardiovascular risk factors , 2006, International Journal of Obesity.

[31]  A. Zanchetti,et al.  Low Muscular Mass and Overestimation of Microalbuminuria by Urinary Albumin/Creatinine Ratio , 2006, Hypertension.

[32]  G. Navis,et al.  A central body fat distribution is related to renal function impairment, even in lean subjects. , 2003, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[33]  G. Leoncini,et al.  Microalbuminuria, cardiovascular, and renal risk in primary hypertension. , 2002, Journal of the American Society of Nephrology : JASN.

[34]  S. Yusuf,et al.  Albuminuria and risk of cardiovascular events, death, and heart failure in diabetic and nondiabetic individuals. , 2001, JAMA.

[35]  G. Eknoyan,et al.  Proteinuria, albuminuria, risk, assessment, detection, elimination (PARADE): a position paper of the National Kidney Foundation. , 1999, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[36]  A. Høegholm,et al.  Microalbuminuria in 411 untreated individuals with established hypertension, white coat hypertension, and normotension. , 1994, Hypertension.