Research Paper|Volume 14, Issue 19|pp 8001—8012

Sex difference in the association between pathological albuminuria and subclinical atherosclerosis: insights from the I-Lan longitudinal aging study

Ya-Wen Lu^1,^2,³, Chun-Chin Chang^2,^3,⁴, Ruey-Hsing Chou^2,^3,^4,⁵, Yi-Lin Tsai^2,^3,⁴, Li-Kuo Liu^6,⁷, Liang-Kung Chen^6,^7,^8,⁹, Po-Hsun Huang^2,^3,^4,⁵, Shing-Jong Lin^2,^3,^4,^9,^10,¹¹

¹Division of Cardiology, Department of Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
²Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
³Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
⁴Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
⁵Department of Critical Care Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
⁶Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
⁷Aging and Health Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
⁸Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan
⁹Taipei Municipal Gan-Dau Hospital, Taipei, Taiwan
¹⁰Taipei Heart Institute, Taipei Medical University, Taipei, Taiwan
¹¹Division of Cardiology, Heart Center, Cheng-Hsin General Hospital, Taipei, Taiwan

Received: April 11, 2022Accepted: September 23, 2022Published: October 11, 2022

https://doi.org/10.18632/aging.204331

Copyright: © 2022 Lu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Background: Pathological albuminuria (PAU) (urinary albumin creatinine ratio [UACR] ≥30 mg/g) is an independent risk factor of cardiovascular disease. PAU is more prevalent in men than women. We aimed to compare the association of PAU and the early phase of subclinical atherosclerosis (SA) between sexes.

Methods: 1228 subjects aged 50–90 years were stratified by sex and UACR (normal or PAU). SA was defined as mean carotid intima-media thickness ≥75th percentile of the cohort. Demographics and SA prevalence were compared between groups. Multivariate logistic regression was performed to assess the relationship between PAU and SA.

Results: Both men and women with PAU had increased prevalence of hypertension, anti-hypertensive therapy, and metabolic syndrome than controls. Men with PAU were older and had greater waist circumference and total body fat percentage. Sex disparity was observed in associations between waist-to-height ratio, total body fat, and UACR. After adjusting for traditional risk factors, multivariate logistic regression disclosed that PAU was independently associated with SA in men (adjusted odds ratio 1.867, 95% CI 1.066–3.210) but not in women.

Conclusion: The relationship of PAU and SA differed between sexes. This result may highlight the need for sex-specific risk management strategies to prevent atherosclerosis.