スダ　サトシ   SUDA Satoshi   須田　智    所属   埼玉医科大学  医学部 国際医療センター　神経内科・脳卒中内科    職種   教授
論文種別	学術雑誌(原著)
言語種別	英語
査読の有無	査読あり
表題	Urinary albumin-to-creatinine ratio is associated with white matter lesions severity in first-ever stroke patients
掲載誌名	正式名：JOURNAL OF THE NEUROLOGICAL SCIENCES ISSNコード：0022-510X/1878-5883
出版社	ELSEVIER SCIENCE BV
巻・号・頁	373,258-262頁
著者・共著者	Satoshi Suda,Takuya Kanamaru,Seiji Okubo,Junya Aoki,Takashi Shimoyama,Kentaro Suzuki,Chikako Nito,Akiko Ishiwata,Kazumi Kimura
発行年月	2017/02
概要	Background: The presence of white matter lesions (WML) is an indicator of small vessel disease; however, the underlying pathological mechanisms are still unclear. We aimed to investigate the association of estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (UACR) with WML severity in first-ever stroke patients. Methods: We retrospectively enrolled 284 consecutive patients (177 male; median age 72 years) admitted to our stroke center between May 2010 and January 2012. eGFR and UACR measurements were performed on admission. WML severity was assessed using the Fazekas classification. Severe WML was defined as a Fazekas grade of 2 or higher. The impact of eGFR and UACR on severe WML was evaluated using multiple logistic regression analysis. Results: Age (P < 0.0001), sex (P = 0.0094), eGFR (P = 0.0173), UACR (P = 0.0001), hypertension (P = 0.0436), and brain natriuretic peptide (P = 0.0354) were significantly associated with severe WML. On multivariable logistic regression analysis, high UACR (>= 39.6 mg/g creatinine, P = 0.039), but not low eGFR (<= 74 ml/min/1.73 m(2), P = 0.3672), was independently associated with severe WML. Comparisons between the UACR levels showed that severe WML was more frequent in the UACR mg/g creatinine group than in the UACR <30.0 mg/g creatinine group after multivariate adjustment (OR, 225; 95% CI, 1.04-5.00; P = 0.039). However, there was no significant association between eGFR and severe WML. Conclusions: Our data suggest that high UACR, but not eGFR, is independently associated with severe WML. (C) 2017 Elsevier B.V. All rights reserved.
DOI	10.1016/j.jns.2017.01.011
PMID	28131201