Abstract: Background　Microalbuminuria detection has been widely used in screening and monitoring renal function impairment in ever-increasing chronic kidney disease patients.Studies have shown that albuminuria is an independent predictive factor of the prognosis （including death） of diabetes，hypertension，cardiovascular disease，and kidney damage.Therefore，it is necessary to screen albuminuria in high-risk groups，such as diabetic，hypertensive，and elderly people，as well as those with family history of kidney damage.Objective　To investigate albuminuria prevalence and related clinical and lifestyle risk factors in 50-60-year-old adults from 6 communities in Suzhou's Xiangcheng District.Methods　Participants were 652 50-60-year-old adults from 6 communities in Suzhou's Xiangcheng District.Their physical examination data between May and June，2018，were collected from Suzhou Xiangcheng District Second People's Hospital，including anthropometrical and routine blood parameters，microalbuminuria and creatinine in first-morning urine，and the ratio between （Abbott C8000 automatic biochemical analyzer measured） albumin and creatinine （ACR）.Albuminuria was diagnosed with the criterion of ACR≥2.88 mg/mmol，the cutoff point determined by ROC curve analysis.Albuminuria prevalence was estimated，and its influencing factors were identified by multivariate Logistic regression.Results　ACR ranged 0.29-26.72 mg/mmol in the participants.110 （16.9%） with ACR≥2.88 mg/mmol and 542 （83.1%） with ACR<2.88 mg/mmol were included in albuminuria group，and control group，respectively.There were no significant differences between the groups in exercise status，salt preference and BMI （P>0.05），but the difference in smoking status was obvious （P<0.05）.Albuminuria group showed higher female ratio，prevalence of hypertension and diabetes，and higher average levels of systolic and diastolic blood pressure，triacylglycerol，and fasting blood glucose，but lower average creatinine level compared with the control group （P<0.05）.Albuminuria prevalence did not vary according to exercise status and salt prevalence （P>0.05），but varied by sex，prevalence of hypertension，diabetes and smoking（P<0.05）.Multivariate Logistic regression analysis showed that hypertension，diabetes and smoking were independent influencing factors for albuminuria （P<0.05）.Conclusion　The prevalence of albuminuria is high in community population aged 50-60 years in this district.Female is associated with higher prevalence.Hypertension，diabetes and smoking in men are the risk factors for albuminuria.

Key words: Albuminuria, Community health services, Root cause analysis, Kidney diseases, Albumin, Aged, Cross-sectional studies

摘要： 背景　随着世界范围内慢性肾脏病患者日益增多，尿微量白蛋白检测已广泛应用于肾脏损伤患者的筛查和监测。研究表明白蛋白尿是糖尿病、高血压乃至心血管疾病、肾脏损害预后及死亡的独立预测因子，因此有必要在存在高危因素的人群（如糖尿病、高血压、老年、肾脏损害家族史等）中进行白蛋白尿的筛查。目的　了解苏州市相城区6个社区50~60岁社区人群白蛋白尿的发病情况，探讨该人群白蛋白尿与临床及生活习性风险因素的相关性。方法　2018年5—6月对在苏州市相城区第二人民医院体检的6个社区50~60岁户籍居民进行健康普查，收集该体检人群652例相关体检资料、血液标本及清晨尿液，检测尿微量白蛋白和尿肌酐水平，计算尿白蛋白／肌酐比值（ACR）。根据受试者工作特征（ROC）曲线分析结果，确定本实验室Abbott C8000生化仪检测ACR≥2.88 mg/mmol为诊断临界值（诊断cutoff值）。统计该人群白蛋白尿发生率，并采用多因素Logistic回归分析其危险因素。结果　652例受试者中，ACR 0.29~26.72 mg/mmol，ACR≥2.88 mg/mmol 110例（16.9%）为白蛋白尿组，ACR<2.88 mg/mmol 542例（83.1%）为对照组，两组运动情况、嗜盐程度、BMI比较，差异均无统计学意义（P>0.05）；两组吸烟情况比较，差异有统计学意义（P<0.05）；白蛋白尿组女性比例、高血压及糖尿病发生率、收缩压、舒张压、三酰甘油、空腹血糖水平高于对照组，肌酐水平低于对照组（P<0.05）。不同运动情况、嗜盐程度社区人群白蛋白尿发生率比较，差异均无统计学意义（P>0.05）；不同性别、是否合并高血压及糖尿病、不同吸烟情况社区人群白蛋白尿发生率比较，差异均有统计学意义（P<0.05）。多因素Logistic回归分析结果显示，高血压、糖尿病、吸烟情况是发生白蛋白尿的独立影响因素（P<0.05）。结论　该地区50~60岁社区人群白蛋白尿发生率较高，女性高于男性。其中高血压、糖尿病及男性吸烟情况是发生白蛋白尿危险因素。

关键词: 白蛋白尿, 社区卫生服务, 影响因素分析, 肾疾病, 白蛋白, 老年人, 横断面研究