N-Acetyl-β-D-Glucosaminidase Does Not Enhance Prediction of Cardiovascular or All-Cause Mortality by Albuminuria in a Low-Risk Population
Accepted manuscript version. Published version can be found at http://doi.org/10.1681/ASN.2014100960 and in PubMed Central from February 1, 2017. Albuminuria is a well known risk factor for cardiovascular disease and mortality, but focus on renal tubular dysfunction as a potential risk factor is gro...
Published in: | Journal of the American Society of Nephrology |
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2015
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Online Access: | https://hdl.handle.net/10037/10166 https://doi.org/10.1681/ASN.2014100960 |
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ftunivtroemsoe:oai:munin.uit.no:10037/10166 2023-05-15T18:34:54+02:00 N-Acetyl-β-D-Glucosaminidase Does Not Enhance Prediction of Cardiovascular or All-Cause Mortality by Albuminuria in a Low-Risk Population Toft, Ingrid Løchen, Maja-Lisa Mathiesen, Ellisiv B. Eriksen, Bjørn Odvar Melsom, Toralf Njølstad, Inger Wilsgaard, Tom Jenssen, Trond Geir 2015-06-05 https://hdl.handle.net/10037/10166 https://doi.org/10.1681/ASN.2014100960 eng eng American Society of Nephrology Journal of the American Society of Nephrology 2016, 27(2) FRIDAID 1250239 doi:10.1681/ASN.2014100960 1046-6673 https://hdl.handle.net/10037/10166 URN:NBN:no-uit_munin_9257 openAccess albuminuria cardiovascular disease clinical epidemiology mortality risk proximal tubule renal dysfunction VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Nefrologi urologi: 772 Journal article Tidsskriftartikkel Peer reviewed 2015 ftunivtroemsoe https://doi.org/10.1681/ASN.2014100960 2021-06-25T17:54:40Z Accepted manuscript version. Published version can be found at http://doi.org/10.1681/ASN.2014100960 and in PubMed Central from February 1, 2017. Albuminuria is a well known risk factor for cardiovascular disease and mortality, but focus on renal tubular dysfunction as a potential risk factor is growing also. The association between the urinary activity of N-acetyl-β-D-glucosaminidase (NAG) and cardiovascular risk has been assessed mostly in cross-sectional studies. We studied the cross-sectional associations between urinary NAG and cardiovascular risk factors and the longitudinal associations between NAG, cardiovascular disease, and all-cause mortality in a general population. Urinary NAG/creatinine ratio (NAG ratio) and albumin/creatinine ratio (ACR) were measured in 6834 participants of the Tromsø Study in 1994–1995. During the median 17.5 years of follow-up, 958 myocardial infarctions, 726 ischemic strokes, and 2358 deaths were registered. In multivariable analyses adjusted for albuminuria and cardiovascular risk factors, a baseline NAG ratio in the highest quartile was associated with an increased risk of myocardial infarction (hazard ratio [HR], 1.43; 95% confidence interval [95% CI], 1.16 to 1.76), ischemic stroke (HR, 1.41; 95% CI, 1.10 to 1.80), and all-cause mortality (HR, 1.60; 95% CI, 1.39 to 1.84). Combined, ACR and NAG ratio above median associated with a 48%–80% increased risk for the three end points. However, the NAG ratio did not add significantly to the baseline risk-prediction models when assessed by area under the receiver operating characteristics curve or net reclassification improvement. In conclusion, the nonsignificant improvement of risk prediction does not support the clinical use of NAG ratio in cardiovascular risk assessment in a low-risk group. Article in Journal/Newspaper Tromsø University of Tromsø: Munin Open Research Archive Tromsø Journal of the American Society of Nephrology 27 2 533 542 |
institution |
Open Polar |
collection |
University of Tromsø: Munin Open Research Archive |
op_collection_id |
ftunivtroemsoe |
language |
English |
topic |
albuminuria cardiovascular disease clinical epidemiology mortality risk proximal tubule renal dysfunction VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Nefrologi urologi: 772 |
spellingShingle |
albuminuria cardiovascular disease clinical epidemiology mortality risk proximal tubule renal dysfunction VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Nefrologi urologi: 772 Toft, Ingrid Løchen, Maja-Lisa Mathiesen, Ellisiv B. Eriksen, Bjørn Odvar Melsom, Toralf Njølstad, Inger Wilsgaard, Tom Jenssen, Trond Geir N-Acetyl-β-D-Glucosaminidase Does Not Enhance Prediction of Cardiovascular or All-Cause Mortality by Albuminuria in a Low-Risk Population |
topic_facet |
albuminuria cardiovascular disease clinical epidemiology mortality risk proximal tubule renal dysfunction VDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Nefrologi urologi: 772 |
description |
Accepted manuscript version. Published version can be found at http://doi.org/10.1681/ASN.2014100960 and in PubMed Central from February 1, 2017. Albuminuria is a well known risk factor for cardiovascular disease and mortality, but focus on renal tubular dysfunction as a potential risk factor is growing also. The association between the urinary activity of N-acetyl-β-D-glucosaminidase (NAG) and cardiovascular risk has been assessed mostly in cross-sectional studies. We studied the cross-sectional associations between urinary NAG and cardiovascular risk factors and the longitudinal associations between NAG, cardiovascular disease, and all-cause mortality in a general population. Urinary NAG/creatinine ratio (NAG ratio) and albumin/creatinine ratio (ACR) were measured in 6834 participants of the Tromsø Study in 1994–1995. During the median 17.5 years of follow-up, 958 myocardial infarctions, 726 ischemic strokes, and 2358 deaths were registered. In multivariable analyses adjusted for albuminuria and cardiovascular risk factors, a baseline NAG ratio in the highest quartile was associated with an increased risk of myocardial infarction (hazard ratio [HR], 1.43; 95% confidence interval [95% CI], 1.16 to 1.76), ischemic stroke (HR, 1.41; 95% CI, 1.10 to 1.80), and all-cause mortality (HR, 1.60; 95% CI, 1.39 to 1.84). Combined, ACR and NAG ratio above median associated with a 48%–80% increased risk for the three end points. However, the NAG ratio did not add significantly to the baseline risk-prediction models when assessed by area under the receiver operating characteristics curve or net reclassification improvement. In conclusion, the nonsignificant improvement of risk prediction does not support the clinical use of NAG ratio in cardiovascular risk assessment in a low-risk group. |
format |
Article in Journal/Newspaper |
author |
Toft, Ingrid Løchen, Maja-Lisa Mathiesen, Ellisiv B. Eriksen, Bjørn Odvar Melsom, Toralf Njølstad, Inger Wilsgaard, Tom Jenssen, Trond Geir |
author_facet |
Toft, Ingrid Løchen, Maja-Lisa Mathiesen, Ellisiv B. Eriksen, Bjørn Odvar Melsom, Toralf Njølstad, Inger Wilsgaard, Tom Jenssen, Trond Geir |
author_sort |
Toft, Ingrid |
title |
N-Acetyl-β-D-Glucosaminidase Does Not Enhance Prediction of Cardiovascular or All-Cause Mortality by Albuminuria in a Low-Risk Population |
title_short |
N-Acetyl-β-D-Glucosaminidase Does Not Enhance Prediction of Cardiovascular or All-Cause Mortality by Albuminuria in a Low-Risk Population |
title_full |
N-Acetyl-β-D-Glucosaminidase Does Not Enhance Prediction of Cardiovascular or All-Cause Mortality by Albuminuria in a Low-Risk Population |
title_fullStr |
N-Acetyl-β-D-Glucosaminidase Does Not Enhance Prediction of Cardiovascular or All-Cause Mortality by Albuminuria in a Low-Risk Population |
title_full_unstemmed |
N-Acetyl-β-D-Glucosaminidase Does Not Enhance Prediction of Cardiovascular or All-Cause Mortality by Albuminuria in a Low-Risk Population |
title_sort |
n-acetyl-β-d-glucosaminidase does not enhance prediction of cardiovascular or all-cause mortality by albuminuria in a low-risk population |
publisher |
American Society of Nephrology |
publishDate |
2015 |
url |
https://hdl.handle.net/10037/10166 https://doi.org/10.1681/ASN.2014100960 |
geographic |
Tromsø |
geographic_facet |
Tromsø |
genre |
Tromsø |
genre_facet |
Tromsø |
op_relation |
Journal of the American Society of Nephrology 2016, 27(2) FRIDAID 1250239 doi:10.1681/ASN.2014100960 1046-6673 https://hdl.handle.net/10037/10166 URN:NBN:no-uit_munin_9257 |
op_rights |
openAccess |
op_doi |
https://doi.org/10.1681/ASN.2014100960 |
container_title |
Journal of the American Society of Nephrology |
container_volume |
27 |
container_issue |
2 |
container_start_page |
533 |
op_container_end_page |
542 |
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1766219903960875008 |