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Sex difference in the risk for exercise-induced albuminuria correlates with hemoglobin A1C and abnormal exercise ECG test findings.
Brzezinski, Rafael Y; Etz-Hadar, Inbal; Grupper, Ayelet; Ehrenwald, Michal; Shapira, Itzhak; Zeltser, David; Berliner, Shlomo; Rogowski, Ori; Eldor, Roy; Shenhar-Tsarfaty, Shani.
Afiliação
  • Brzezinski RY; Department of Internal Medicine "C", "D" and "E", Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, 6 Weizmann Street, 64239, Tel Aviv, Israel.
  • Etz-Hadar I; Department of Internal Medicine "C", "D" and "E", Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, 6 Weizmann Street, 64239, Tel Aviv, Israel.
  • Grupper A; Nephrology Department, Tel-Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
  • Ehrenwald M; Department of Internal Medicine "C", "D" and "E", Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, 6 Weizmann Street, 64239, Tel Aviv, Israel.
  • Shapira I; Department of Internal Medicine "C", "D" and "E", Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, 6 Weizmann Street, 64239, Tel Aviv, Israel.
  • Zeltser D; Department of Internal Medicine "C", "D" and "E", Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, 6 Weizmann Street, 64239, Tel Aviv, Israel.
  • Berliner S; Department of Internal Medicine "C", "D" and "E", Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, 6 Weizmann Street, 64239, Tel Aviv, Israel.
  • Rogowski O; Department of Internal Medicine "C", "D" and "E", Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, 6 Weizmann Street, 64239, Tel Aviv, Israel.
  • Eldor R; Diabetes Unit, Institute of Endocrinology, Metabolism and Hypertension, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
  • Shenhar-Tsarfaty S; Department of Internal Medicine "C", "D" and "E", Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, 6 Weizmann Street, 64239, Tel Aviv, Israel. shanis@tlvmc.gov.il.
Cardiovasc Diabetol ; 16(1): 79, 2017 06 23.
Article em En | MEDLINE | ID: mdl-28645281
BACKGROUND: Albuminuria is an established marker for endothelial dysfunction and cardiovascular risk in diabetes and prediabetes. Exercise induced albuminuria (EiA) appears earlier and may be a more sensitive biomarker for renal endothelial damage. We sought to examine the association between EiA, parameters of the metabolic syndrome, A1C levels, exercise ECG test results and sex related differences in a large cohort of healthy, pre-diabetic and diabetic subjects. METHODS: A total of 3029 participants from the Tel-Aviv Medical Center Inflammation Survey cohort (mean age 46 years, 73% men) were analyzed. Multiple physiologic and metabolic parameters including A1C were collected and albuminuria was measured in all subjects before and immediately after completing an exercise ECG test. RESULTS: Exercise increased urinary albumin to creatinine ratio (ΔEiA) by 2.8 (0-13.6) mg/g for median (IQR) compared to rest albuminuria (p < 0.001). An increase in ΔEiA was observed with accumulating parameters of the metabolic syndrome. ΔEiA showed significant interaction with sex and A1C levels; i.e. women with A1C > 6.5% had an increased risk of higher ΔEiA (p < 0.001). Using a cutoff of ΔEiA > 13 mg/g (top quartile) we found that women with ΔEiA > 13 mg/g were at greater risk for abnormal exercise ECG findings, (OR = 2.7, p = 0.001). CONCLUSION: Exercise promotes excessive urinary albumin excretion in dysmetabolic patients. In women, a significant correlation exists between ΔEiA and A1C levels. A cutoff of ΔEiA > 13 mg/g in women may be used to identify populations at risk for abnormal exercise ECG test findings and perhaps increased cardiovascular risk. Future studies will be needed to further validate the usefulness of ΔEiA as a biomarker for cardiovascular risk in women with and without diabetes.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Hemoglobinas Glicadas / Exercício Físico / Caracteres Sexuais / Albuminúria / Eletrocardiografia Tipo de estudo: Diagnostic_studies / Etiology_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Cardiovasc Diabetol Assunto da revista: ANGIOLOGIA / CARDIOLOGIA / ENDOCRINOLOGIA Ano de publicação: 2017 Tipo de documento: Article País de afiliação: Israel

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Hemoglobinas Glicadas / Exercício Físico / Caracteres Sexuais / Albuminúria / Eletrocardiografia Tipo de estudo: Diagnostic_studies / Etiology_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Cardiovasc Diabetol Assunto da revista: ANGIOLOGIA / CARDIOLOGIA / ENDOCRINOLOGIA Ano de publicação: 2017 Tipo de documento: Article País de afiliação: Israel