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The role of urinary albumin-to-creatinine ratio as a biomarker to predict stroke: A meta-analysis and systemic review

Albuminuria excretion rate, calculated as urinary albumin-to-creatinine ratio (UACR), is used clinically to evaluate albuminuria. There are different attitudes to whether high UACR predicts higher risk of stroke. The aim of this study was to evaluate the relationship between UACR and stroke. Two inv...

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Published in:	Brain circulation 2021-07, Vol.7 (3), p.139-146
Main Authors:	Li, Min, Cheng, Aichun, Sun, Jingkun, Fan, Chunqiu, Meng, Ran
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Language:	English
Subjects:	Albumin Analysis biomarker Clopidogrel meta-analysis Review stroke systemic review urinary albumin-to-creatinine ratio
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description	Albuminuria excretion rate, calculated as urinary albumin-to-creatinine ratio (UACR), is used clinically to evaluate albuminuria. There are different attitudes to whether high UACR predicts higher risk of stroke. The aim of this study was to evaluate the relationship between UACR and stroke. Two investigators independently searched MEDLINE, EMBASE, Cochrane Controlled Trials Register Database, Scopus and Google Scholar from January 1966 through June 2021 were screened. In addition, a manual search was conducted using the bibliographies of original papers and review articles on this topic. Two blinded reviewers abstracted the data independently to a predefined form. Among the 10,939 initially identified studies, 7 studies with 159,302 subjects were finally included. It is demonstrated that UACR predicted an increased risk of stroke using cutoff value of either 0.43 (HR, 2.39; 95% CI: 1.24 - 4.61; P
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There are different attitudes to whether high UACR predicts higher risk of stroke. The aim of this study was to evaluate the relationship between UACR and stroke. Two investigators independently searched MEDLINE, EMBASE, Cochrane Controlled Trials Register Database, Scopus and Google Scholar from January 1966 through June 2021 were screened. In addition, a manual search was conducted using the bibliographies of original papers and review articles on this topic. Two blinded reviewers abstracted the data independently to a predefined form. Among the 10,939 initially identified studies, 7 studies with 159,302 subjects were finally included. It is demonstrated that UACR predicted an increased risk of stroke using cutoff value of either 0.43 (HR, 2.39; 95% CI: 1.24 - 4.61; P <0.01), 10 mg/g (HR, 1.60; 95% CI: 1.30 - 1.97; P < 0.01) or 30 mg/g (HR, 1.84; 95% CI: 1.49 - 2.28; P < 0.01). The overall analysis confirmed that high UACR was associated with an increased rate of stroke (HR, 1.81; 95% CI: 1.52 - 2.17; P < 0.01). Furthermore, High UACR predicted higher risk of stroke in local inhabitants (HR, 1.67; 95% CI: 1.17 – 2.37; P = 0.04), adults (HR, 2.21; 95% CI: 2.07 – 2.36; P < 0.01) or elderly adults (HR, 1.96; 95% CI: 1.56 – 2.46; P < 0.01). Whereas, high UACR was unable to predict stroke in patients with either T2DM (HR, 2.25; 95% CI: 0.55 – 9.17; P = 0.26) or hypertension (HR, 0.95; 95% CI: 0.28 – 3.22; P = 0.93). Another subgroup analysis revealed that high UACR was associated with increased risk of ischemic stroke (HR, 1.60; 95% CI: 1.43 - 1.80; P < 0.01), as well as hemorrhagic stroke (HR, 1.76; 95% CI: 1.22 - 1.45; P < 0.01). In conclusion, UACR is associated with an increased risk of hemorrhagic and ischemic stroke. UACR may be used as an indicator to predict stroke in non-diabetic and non-hypertensive subjects.]]></description><identifier>ISSN: 2394-8108</identifier><identifier>ISSN: 2455-4626</identifier><identifier>EISSN: 2455-4626</identifier><identifier>DOI: 10.4103/bc.bc_64_20</identifier><identifier>PMID: 34667897</identifier><language>eng</language><publisher>India: Medknow Publications and Media Pvt. Ltd</publisher><subject>Albumin ; Analysis ; biomarker ; Clopidogrel ; meta-analysis ; Review ; stroke ; systemic review ; urinary albumin-to-creatinine ratio</subject><ispartof>Brain circulation, 2021-07, Vol.7 (3), p.139-146</ispartof><rights>COPYRIGHT 2021 Medknow Publications and Media Pvt. Ltd.</rights><rights>Copyright: © 2021 Brain Circulation 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c415t-fdff3cd23bddc58b71038a222b6d06dd262b4c72c869eec7fd186764e9c305003</citedby><cites>FETCH-LOGICAL-c415t-fdff3cd23bddc58b71038a222b6d06dd262b4c72c869eec7fd186764e9c305003</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8459689/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8459689/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27903,27904,36992,53769,53771</link.rule.ids></links><search><creatorcontrib>Li, Min</creatorcontrib><creatorcontrib>Cheng, Aichun</creatorcontrib><creatorcontrib>Sun, Jingkun</creatorcontrib><creatorcontrib>Fan, Chunqiu</creatorcontrib><creatorcontrib>Meng, Ran</creatorcontrib><title>The role of urinary albumin-to-creatinine ratio as a biomarker to predict stroke: A meta-analysis and systemic review</title><title>Brain circulation</title><description><![CDATA[Albuminuria excretion rate, calculated as urinary albumin-to-creatinine ratio (UACR), is used clinically to evaluate albuminuria. There are different attitudes to whether high UACR predicts higher risk of stroke. The aim of this study was to evaluate the relationship between UACR and stroke. Two investigators independently searched MEDLINE, EMBASE, Cochrane Controlled Trials Register Database, Scopus and Google Scholar from January 1966 through June 2021 were screened. In addition, a manual search was conducted using the bibliographies of original papers and review articles on this topic. Two blinded reviewers abstracted the data independently to a predefined form. Among the 10,939 initially identified studies, 7 studies with 159,302 subjects were finally included. It is demonstrated that UACR predicted an increased risk of stroke using cutoff value of either 0.43 (HR, 2.39; 95% CI: 1.24 - 4.61; P <0.01), 10 mg/g (HR, 1.60; 95% CI: 1.30 - 1.97; P < 0.01) or 30 mg/g (HR, 1.84; 95% CI: 1.49 - 2.28; P < 0.01). The overall analysis confirmed that high UACR was associated with an increased rate of stroke (HR, 1.81; 95% CI: 1.52 - 2.17; P < 0.01). Furthermore, High UACR predicted higher risk of stroke in local inhabitants (HR, 1.67; 95% CI: 1.17 – 2.37; P = 0.04), adults (HR, 2.21; 95% CI: 2.07 – 2.36; P < 0.01) or elderly adults (HR, 1.96; 95% CI: 1.56 – 2.46; P < 0.01). Whereas, high UACR was unable to predict stroke in patients with either T2DM (HR, 2.25; 95% CI: 0.55 – 9.17; P = 0.26) or hypertension (HR, 0.95; 95% CI: 0.28 – 3.22; P = 0.93). Another subgroup analysis revealed that high UACR was associated with increased risk of ischemic stroke (HR, 1.60; 95% CI: 1.43 - 1.80; P < 0.01), as well as hemorrhagic stroke (HR, 1.76; 95% CI: 1.22 - 1.45; P < 0.01). In conclusion, UACR is associated with an increased risk of hemorrhagic and ischemic stroke. UACR may be used as an indicator to predict stroke in non-diabetic and non-hypertensive subjects.]]></description><subject>Albumin</subject><subject>Analysis</subject><subject>biomarker</subject><subject>Clopidogrel</subject><subject>meta-analysis</subject><subject>Review</subject><subject>stroke</subject><subject>systemic review</subject><subject>urinary albumin-to-creatinine ratio</subject><issn>2394-8108</issn><issn>2455-4626</issn><issn>2455-4626</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>DOA</sourceid><recordid>eNptkt1rFDEQwBdRbKl98h8ICCLInvne7ItQitpCQR_qc8jH5C7t3uZMsoX-9-a8WjyQPGSY_ObHDJmue0vwihPMPlm3sk5Lril-0Z1SLkTPJZUvW8xG3iuC1Ul3XsodxpgMiolBvu5OGJdyUONw2v243QDKaQKUAlpynE1-RGayyzbOfU29y2BqnOPcqBYkZAoyyMa0NfkeMqoJ7TL46CoqNad7eNO9CmYqcP50n3U_v365vbzqb75_u768uOkdJ6L2wYfAnKfMeu-EskMbRhlKqZUeS--ppJa7gTolRwA3BE-UHCSH0TEsMGZn3fXB65O507scW0OPOpmo_yRSXmuTa3QTaOKlJFgG4hXhHsACk1x44-jIHFasuT4fXLvFbsE7mGs205H0-GWOG71OD1pxMUo1NsGHJ0FOvxYoVW9jcTBNZoa0FE2F4phQSkRD3x3QtWmtxTmkZnR7XF_IgakBq3EvXP2HasfDNro0Q4gtf1Tw_p-CDZipbkqalvZlczkGPx5Al1MpGcLzmATr_Urptk9_V4r9BnoYvH4</recordid><startdate>20210701</startdate><enddate>20210701</enddate><creator>Li, Min</creator><creator>Cheng, Aichun</creator><creator>Sun, Jingkun</creator><creator>Fan, Chunqiu</creator><creator>Meng, Ran</creator><general>Medknow Publications and Media Pvt. Ltd</general><general>Wolters Kluwer - Medknow</general><general>Wolters Kluwer Medknow Publications</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20210701</creationdate><title>The role of urinary albumin-to-creatinine ratio as a biomarker to predict stroke</title><author>Li, Min ; Cheng, Aichun ; Sun, Jingkun ; Fan, Chunqiu ; Meng, Ran</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c415t-fdff3cd23bddc58b71038a222b6d06dd262b4c72c869eec7fd186764e9c305003</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Albumin</topic><topic>Analysis</topic><topic>biomarker</topic><topic>Clopidogrel</topic><topic>meta-analysis</topic><topic>Review</topic><topic>stroke</topic><topic>systemic review</topic><topic>urinary albumin-to-creatinine ratio</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Li, Min</creatorcontrib><creatorcontrib>Cheng, Aichun</creatorcontrib><creatorcontrib>Sun, Jingkun</creatorcontrib><creatorcontrib>Fan, Chunqiu</creatorcontrib><creatorcontrib>Meng, Ran</creatorcontrib><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Brain circulation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Li, Min</au><au>Cheng, Aichun</au><au>Sun, Jingkun</au><au>Fan, Chunqiu</au><au>Meng, Ran</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The role of urinary albumin-to-creatinine ratio as a biomarker to predict stroke: A meta-analysis and systemic review</atitle><jtitle>Brain circulation</jtitle><date>2021-07-01</date><risdate>2021</risdate><volume>7</volume><issue>3</issue><spage>139</spage><epage>146</epage><pages>139-146</pages><issn>2394-8108</issn><issn>2455-4626</issn><eissn>2455-4626</eissn><abstract><![CDATA[Albuminuria excretion rate, calculated as urinary albumin-to-creatinine ratio (UACR), is used clinically to evaluate albuminuria. There are different attitudes to whether high UACR predicts higher risk of stroke. The aim of this study was to evaluate the relationship between UACR and stroke. Two investigators independently searched MEDLINE, EMBASE, Cochrane Controlled Trials Register Database, Scopus and Google Scholar from January 1966 through June 2021 were screened. In addition, a manual search was conducted using the bibliographies of original papers and review articles on this topic. Two blinded reviewers abstracted the data independently to a predefined form. Among the 10,939 initially identified studies, 7 studies with 159,302 subjects were finally included. It is demonstrated that UACR predicted an increased risk of stroke using cutoff value of either 0.43 (HR, 2.39; 95% CI: 1.24 - 4.61; P <0.01), 10 mg/g (HR, 1.60; 95% CI: 1.30 - 1.97; P < 0.01) or 30 mg/g (HR, 1.84; 95% CI: 1.49 - 2.28; P < 0.01). The overall analysis confirmed that high UACR was associated with an increased rate of stroke (HR, 1.81; 95% CI: 1.52 - 2.17; P < 0.01). Furthermore, High UACR predicted higher risk of stroke in local inhabitants (HR, 1.67; 95% CI: 1.17 – 2.37; P = 0.04), adults (HR, 2.21; 95% CI: 2.07 – 2.36; P < 0.01) or elderly adults (HR, 1.96; 95% CI: 1.56 – 2.46; P < 0.01). Whereas, high UACR was unable to predict stroke in patients with either T2DM (HR, 2.25; 95% CI: 0.55 – 9.17; P = 0.26) or hypertension (HR, 0.95; 95% CI: 0.28 – 3.22; P = 0.93). Another subgroup analysis revealed that high UACR was associated with increased risk of ischemic stroke (HR, 1.60; 95% CI: 1.43 - 1.80; P < 0.01), as well as hemorrhagic stroke (HR, 1.76; 95% CI: 1.22 - 1.45; P < 0.01). In conclusion, UACR is associated with an increased risk of hemorrhagic and ischemic stroke. UACR may be used as an indicator to predict stroke in non-diabetic and non-hypertensive subjects.]]></abstract><cop>India</cop><pub>Medknow Publications and Media Pvt. Ltd</pub><pmid>34667897</pmid><doi>10.4103/bc.bc_64_20</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record>
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subjects	Albumin Analysis biomarker Clopidogrel meta-analysis Review stroke systemic review urinary albumin-to-creatinine ratio
title	The role of urinary albumin-to-creatinine ratio as a biomarker to predict stroke: A meta-analysis and systemic review
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