scholarly journals Cross-sectional associations between central and general adiposity with albuminuria: observations from 400,000 people in UK Biobank

2020 ◽  
Vol 44 (11) ◽  
pp. 2256-2266
Author(s):  
Pengfei Zhu ◽  
Sarah Lewington ◽  
Richard Haynes ◽  
Jonathan Emberson ◽  
Martin J. Landray ◽  
...  
Keyword(s):  
Measurement Error ◽  
Urinary Albumin ◽  
Glycosylated Haemoglobin ◽  
Creatinine Ratio ◽  
Central Adiposity ◽  
Uk Biobank ◽  
Cross Sectional ◽  
Waist To Hip Ratio ◽  
Baseline Bmi ◽  
General Adiposity

Abstract Background Whether measures of central adiposity are more or less strongly associated with risk of albuminuria than body mass index (BMI), and by how much diabetes/levels of glycosylated haemoglobin (HbA1c) explain or modify these associations, is uncertain. Methods Ordinal logistic regression was used to estimate associations between values of central adiposity (waist-to-hip ratio) and, separately, general adiposity (BMI) with categories of urinary albumin-to-creatinine ratio (uACR) in 408,527 UK Biobank participants. Separate central and general adiposity-based models were initially adjusted for potential confounders and measurement error, then sequentially, models were mutually adjusted (e.g. waist-to-hip ratio adjusted for BMI, and vice versa), and finally they were adjusted for potential mediators. Results Levels of albuminuria were generally low: 20,425 (5%) had a uACR ≥3 mg/mmol. After adjustment for confounders and measurement error, each 0.06 higher waist-to-hip ratio was associated with a 55% (95%CI 53–57%) increase in the odds of being in a higher uACR category. After adjustment for baseline BMI, this association was reduced to 32% (30–34%). Each 5 kg/m2 higher BMI was associated with a 47% (46–49%) increase in the odds of being in a higher uACR category. Adjustment for baseline waist-to-hip ratio reduced this association to 35% (33–37%). Those with higher HbA1c were at progressively higher odds of albuminuria, but positive associations between both waist-to-hip ratio and BMI were apparent irrespective of HbA1c. Altogether, about 40% of central adiposity associations appeared to be mediated by diabetes, vascular disease and blood pressure. Conclusions Conventional epidemiological approaches suggest that higher waist-to-hip ratio and BMI are independently positively associated with albuminuria. Adiposity–albuminuria associations appear strong among people with normal HbA1c, as well as people with pre-diabetes or diabetes.

scholarly journals Association between obesity and urinary albumin-creatinine ratio in the middle-aged and elderly population of Southern and Northern China: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e040214
Author(s):  
Shan Qin ◽  
Anping Wang ◽  
Shi Gu ◽  
Weiqing Wang ◽  
Zhengnan Gao ◽  
...  
Keyword(s):  
Kidney Diseases ◽  
Northern China ◽  
Cross Sectional Study ◽  
Urinary Albumin ◽  
Creatinine Ratio ◽  
Sectional Study ◽  
The South ◽  
Northern Population ◽  
Cross Sectional ◽  
Albumin Creatinine Ratio

ObjectiveThe relationship between obesity and albuminuria has not been clarified. This study aimed to investigate the correlation between obesity and the urinary albumin-creatinine ratio (UACR) in Southern and Northern China.DesignA descriptive, cross-sectional study.SettingEight regional centres in REACTION (China’s Risk Evaluation of cAncers in Chinese diabeTic Individuals, a lONgitudinal study), including Dalian, Lanzhou, Zhengzhou, Guangzhou, Guangxi, Luzhou, Shanghai and Wuhan.ParticipantsA total of 41 085 patients who were not diagnosed with chronic kidney disease (CKD) and had good compliance were selected according to the inclusion criteria. Patients who were diagnosed with CKD, who had other kidney diseases that could lead to increased urinary protein excretion, who were using angiotensin-converting-enzyme inhibitors or angiotensin II receptor blockers and whose important data were missing were excluded.ResultsParticipants with both, central and peripheral obesity, had a higher risk of elevated UACR, even after adjusting for multiple factors (OR: 1.14, 95% CI: 1.07 to 1.12, p<0.001), and the risk of high UACR in the South was more prominent than that in the North (OR South: 1.22, 95% CI: 1.11 to 1.34; OR North: 1.13, 95% CI: 1.04 to 1.22, p<0.001). The risk was also elevated in the male population, hypertensive individuals, glycosylated haemoglobin (HbA1c)≥6.5% and age ≥60 years in the South. Besides the above groups, diabetes was also a risk factor for the Northern population.ConclusionsIn China, people with both central and peripheral obesity are prone to a high UACR, and the southern population has a higher risk than northern population. Factors such as male sex, hypertension, HbA1c≥6.5% and an age ≥60 years are also risk factors for CKD.

scholarly journals METS-IR, a novel score to evaluate insulin sensitivity, is associated with the urinary albumin–creatinine ratio in Chinese adults: A cross-sectional REACTION study

2021 ◽  
Author(s):  
Wanlu Su ◽  
Jie Wang ◽  
Songyan Yu ◽  
Kang Chen ◽  
Wenhua Yan ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Blood Pressure ◽  
Blood Glucose ◽  
Fasting Blood Glucose ◽  
Urinary Albumin ◽  
Postprandial Blood Glucose ◽  
Creatinine Ratio ◽  
Discriminative Ability ◽  
Cross Sectional ◽  
Albumin Creatinine Ratio

Abstract BackgroundThe metabolic score for insulin resistance (METS-IR) is a novel noninsulin-based metabolic index used as a substitution marker of insulin resistance. However, whether METS-IR is associated with the urinary albumin–creatinine ratio (UACR) is not well known. Therefore, we explored the associations between METS-IR and UACR and compared the discriminative ability of METS-IR and its components for elevated UACR. MethodsThis study included 37,290 subjects. METS-IR was calculated as follows: (Ln [2 × fasting blood glucose (FBG) + fasting triglyceride level (TG 0 )] × body mass index (BMI))/[Ln (high-density lipoprotein cholesterol (HDL-C))]. Participants were divided into four groups on the basis of METS-IR: <25%, 25%–49%, 50%–74%, and ≥75%. Logistic regression analyses were conducted to determine the associations between METS-IR vs. its components (FBG, TG 0 , BMI, and HDL-C) with UACR. ResultsParticipants with the highest quartile METS-IR presented a more significant trend towards elevated UACR than towards its components (odds ratio [OR]: 1.260, 95% CI: 1.152–1.378, P < 0.001 in all subjects; OR: 1.321, 95% CI: 1.104–1.579, P = 0.002 in men; OR: 1.201, 95% CI: 1.083–1.330, P < 0.001 in women). There were significant associations between METS-IR and UACR in younger participants (<65 years for women and 55–64 years for men). Increased METS-IR was significantly associated with UACR in men with FBG ≥ 5.6 mmol/L or postprandial blood glucose ≥ 7.8 mmol/L and systolic blood pressure ≥ 120 mmHg or diastolic blood pressure ≥ 80 mmHg. The relationships were significant in women with diabetes and hypertension.ConclusionsIncreased METS-IR was significantly associated with elevated UACR, and its discriminative power for elevated UACR was superior to that of its components. This findings support the clinical significance of METS-IR for evaluating renal function damage.

scholarly journals Association of central adiposity with psoriasis, psoriatic arthritis and rheumatoid arthritis: a cross-sectional study of the UK Biobank

Rheumatology ◽  
2019 ◽  
Vol 58 (12) ◽  
pp. 2137-2142 ◽  
Author(s):  
Lyn D Ferguson ◽  
Rosemary Brown ◽  
Carlos Celis-Morales ◽  
Paul Welsh ◽  
Donald M Lyall ◽  
...  
Keyword(s):  
Waist Circumference ◽  
Smoking Status ◽  
Cross Sectional Study ◽  
Central Adiposity ◽  
Uk Biobank ◽  
Sectional Study ◽  
Cross Sectional ◽  
Independent Association ◽  
The Uk

AbstractObjectivesTo determine the independent association of central adiposity, assessed by waist circumference, with odds of psoriasis, PsA and RA prevalence after controlling for general adiposity (BMI).MethodsA cross-sectional study of UK Biobank participants aged 40–70 years was performed. Logistic regression was used to calculate the odds of psoriasis, PsA and RA occurrence compared with controls without these conditions by waist circumference, adjusting for covariates: age, sex, smoking status, socioeconomic deprivation and self-reported physical activity (Model 1), followed additionally by BMI (Model 2).ResultsA total of 502 417 participants were included; 5074 with psoriasis (1.02%), 905 with PsA (0.18%), 5532 with RA (1.11%) and 490 906 controls without these conditions. Adjusted odds ratios (ORs) (Model 1) for psoriasis, PsA and RA, per s.d. (13.5 cm) higher waist circumference were 1.20 (95% CI 1.16, 1.23), 1.30 (95% CI 1.21, 1.39) and 1.21 (95% CI 1.17, 1.24), respectively (all P < 0.001). These ORs remained significant after further adjustment for BMI (Model 2) in psoriasis [OR 1.19 (95% CI 1.12, 1.27), P < 0.001] and RA [OR 1.19 (95% CI 1.12, 1.26), P < 0.001], but not in PsA [OR 1.11 (95% CI 0.95, 1.29), P = 0.127].ConclusionCentral adiposity as measured by waist circumference is associated with greater odds of psoriasis and RA prevalence after adjustment for confounders and for BMI. Our findings add support for central adiposity as a long-term clinically relevant component of these conditions.

scholarly journals Skipping Breakfast and a Meal at School: Its Correlates in Adiposity Context. Report from the ABC of Healthy Eating Study of Polish Teenagers

Nutrients ◽  
2019 ◽  
Vol 11 (7) ◽  
pp. 1563 ◽  
Author(s):  
Lidia Wadolowska ◽  
Jadwiga Hamulka ◽  
Joanna Kowalkowska ◽  
Natalia Ulewicz ◽  
Magdalena Gornicka ◽  
...  
Keyword(s):  
Physical Activity ◽  
Screen Time ◽  
Short Form ◽  
Female Gender ◽  
Nutrition Knowledge ◽  
Central Adiposity ◽  
School Students ◽  
Cross Sectional ◽  
Skipping Breakfast ◽  
General Adiposity

Little is known on skipping breakfast and a meal at school, especially considered together. The study identified nutrition knowledge-related, lifestyle (including diet quality, physical activity, and screen time) and socioeconomic correlates of skipping breakfast and a meal at school, considered together or alone and assessed the association of skipping these meals with adiposity markers in Polish teenagers. The sample consisted of 1566 fourth and fifth grade elementary school students (11–13 years). The study was designed as a cross-sectional study. Data related to the consumption of selected food items and meals, physical activity, screen time, sociodemographic factors, and nutrition knowledge (all self-reported) were collected (in 2015–2016) with a short form of a food frequency questionnaire. Respondents reported the usual consumption of breakfast (number of days/week) and a meal or any food eaten at school (number of school days/week) labelled as ‘a meal at school’. The measurements of body weight, height, and waist circumference were taken. BMI-for-age ≥25 kg/m2 was considered as a marker of overweight/obesity (general adiposity), while waist-to-height ratio ≥0.5 as a marker of central obesity (central adiposity). A multivariate logistic regression was applied to verify the association between variables. A total of 17.4% of teenagers frequently skipped breakfast (4–7 days/week), 12.9% frequently skipped a meal at school (3–5 school days/week), while 43.6% skipped both of these meals a few times a week. Predictors of skipping breakfast and/or a meal at school were female gender, age over 12 years, urban residence, lower family affluence, lower nutrition knowledge, higher screen time, and lower physical activity. In comparison to “never-skippers,” “frequent breakfast skippers” were more likely to be overweight/obese (odds ratio, OR 1.89; 95% confidence interval, 95%CI 1.38, 2.58) and centrally obese (OR 1.63; 95%CI 1.09, 2.44), while skippers a few times a week of both of these meals were more likely to be overweight/obese (OR 1.37; 95%CI 1.06, 1.78). Concluding, we estimated that a large percentage of Polish teenagers (approx. 44%) usually skipped both breakfast and a meal at school a few times a week. Similar predictors of skipping breakfast and predictors of skipping a meal at school were identified. Special attention should be paid to promoting shortening screen time and increasing physical activity and teenagers’ nutrition knowledge which are relatively easily modifiable correlates. The study shows that skipping both of these meals a few times a week was associated with general adiposity and also strengthens previous evidence showing the association of frequent skipping breakfast with general and central adiposity.

scholarly journals Adiposity and blood pressure among 55 000 relatively lean rural adults in southwest of China

2015 ◽  
Vol 29 (9) ◽  
pp. 522-529 ◽  
Author(s):  
X Chen ◽  
H Du ◽  
J Zhang ◽  
X Chen ◽  
G Luo ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Rural China ◽  
Central Adiposity ◽  
Regression Analyses ◽  
Chinese Adults ◽  
Rural County ◽  
Cross Sectional ◽  
Mean Values ◽  
Relationship Of ◽  
General Adiposity

Abstract Obesity is a strong determinant of blood pressure. Uncertainty remains, however, about which indices of adiposity most strongly predict blood pressure, particularly among those who were relatively lean, such as those from rural China. We analyzed cross-sectional data on 55 687 (38.3% men) participants aged 30–79 years who were enrolled into the China Kadoorie Biobank from a rural county in southwest of China during 2004–2008. Measured body mass index (BMI) and waist circumference (WC) were related to blood pressure in multivariable linear regression analyses. The overall mean values of BMI, WC, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 23.3 kg m−2, 78.0 cm, 129.2 mm Hg and 77.2 mm Hg, respectively. There was a strongly positive, and apparently linear, relationship of BMI and WC with blood pressure, with 1 s.d. higher BMI associated with 4.3/2.3 mm Hg higher SBP/DBP and 1 s.d. WC associated with 3.8/2.1 mm Hg (P<0.0001). Additional adjustment for WC only slightly attenuated the association of BMI with blood pressure, whereas additional adjustment for BMI almost completely eliminated the association of WC with blood pressure. Our findings suggest that in relatively lean Chinese adults, general adiposity is more strongly assciated with blood pressure than central adiposity.

scholarly journals Differential impact of adiposity on risk of atrial fibrillation in men and women in UK Biobank

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C.J.F Camm ◽  
B Lacey ◽  
B Casadei ◽  
J.C Hopewell
Keyword(s):  
Body Fat ◽  
Fat Mass ◽  
Lean Mass ◽  
Fat Distribution ◽  
Body Fat Mass ◽  
Central Adiposity ◽  
Uk Biobank ◽  
Men And Women ◽  
Independent Effects ◽  
General Adiposity

Abstract Background Atrial fibrillation (AF) and obesity are common conditions with important health implications. Greater adiposity has been associated with higher risk of AF. However, body fat distribution differs between sexes, and the independent effects of different adiposity measures on AF risk remain unclear. Purpose To establish the independent effects of general and central adiposity on risk of incident AF in men and women. Methods UK Biobank is a prospective study involving 502,536 adults (aged 40–69). Participants underwent an extensive baseline interview and physical assessment (including bio-impedance measurements). Incident AF cases were identified by linkage to national hospital statistics and death registry data. Cox regression models adjusted for age, sex, ethnicity, deprivation, smoking and alcohol, were used to estimate effects of general adiposity (body mass index [BMI] and body fat mass), central adiposity (waist circumference [WC]), and lean mass, on risk of incident AF (per sex-specific standard deviation [SD]). Results Among 477,918 participants (mean age 56.4 years, SD 8.1; 45% men) with no history of AF, mean BMI was similar in women (27.0kg/m2, SD 5.0) and men (27.8kg/m2, SD 4.1). Conversely, mean WC was lower in women (84.5cm, SD 12.3) than men (96.8cm, SD 11.0), while mean body fat mass was higher in women (26.9kg, SD 9.8) than men (22.2kg, SD 8.0). A total of 14,362 incident AF events were identified (5,254 in women, 9,108 in men) over 8.1 years median follow-up. AF was positively associated with adiposity. A 1-SD higher BMI, equivalent to 4.6kg/m2, and a 1-SD higher WC, equivalent to 11.7cm, were each associated with &gt;30% higher risks of AF (hazard ratio [HR] BMI 1.32 [95% CI 1.30–1.34]; WC 1.37 [1.35–1.39]), and showed no sex differences. Lean mass was also strongly associated with AF (1.41 [1.39–1.43]), and similar between sexes. In contrast, a 1-SD higher body fat mass, equivalent to 9.0kg, was associated with a 34% higher risk of AF overall (1.34 [1.32–1.36]), but had a stronger effect in women (1.41 [1.38–1.45]) than men (1.30 [1.28–1.33]), p-interaction 1x10–6; albeit effects were comparable per kg). After adjustment for body fat mass and lean mass, WC remained positively associated with AF overall (1.19 [1.15–1.23]) and in both sexes (1.14 [1.09–1.20] in women, 1.21 [1.17–1.26] in men). However, following adjustment for lean mass and WC, body fat mass remained positively associated with AF (1.09 [1.06–1.12]) overall, and in women (1.19 [1.14–1.26]) but was almost completely attenuated in men (1.04 [1.01–1.08]), p-interaction 0.004 (Figure). Associations were not materially changed by further adjustment for height, or by excluding those with prior vascular disease. Conclusions Central adiposity is strongly and independently associated with AF in both sexes. Conversely, general adiposity is independently associated with risk of AF in women but not men. Suggesting the impact fat distribution on AF risk differs by sex. Fat mass, waist circumference & AF risk Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): British Heart Foundation

scholarly journals Prevalence of Metabolic Syndrome and Urinary Albumin to Creatinine Ratio as a Predictor of Cardiovascular Disease in Metabolic Syndrome Patients

2020 ◽  
Author(s):  
Shahid Iqbal ◽  
Anju Mittal ◽  
Sudeep Kumar ◽  
Sumesh Prasad Sah ◽  
Imran Mustafa ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Uttar Pradesh ◽  
Cross Sectional Study ◽  
Urinary Albumin ◽  
P Value ◽  
Creatinine Ratio ◽  
Anthropometric Parameters ◽  
Cross Sectional ◽  
Urine Albumin

Introduction: Metabolic Syndrome (MetS) is a condition that increases the risk of cardiac disease, diabetes, hypertension and may be associated with microalbuminuria. Aim: To investigate the prevalence of metabolic syndrome and to determine albumin to creatinine ratio as a predictor of cardiovascular disease in metabolic syndrome. Materials and Methods: This was a hospital based cross-sectional study conducted from February 2019 to January 2020 in the Department of Biochemistry and Outpatient Department of Muzaffarnagar Medical College, Muzaffarnagar, Uttar Pradesh. Out of enrolled 795 subjects, 452 were male and 343 were female. The prevalence of metabolic syndrome was calculated on the basis of metabolic syndrome criteria. Anthropometric parameters like age, weight, height, blood pressure and the biochemical parameters including fasting blood sugar, triglyceride, Lipid Accumulation Product (LAP), urinary albumin, serum creatinine and urinary Albumin to Creatinine Ratio were measured in study population. SPSS version 16 was used for statistical analysis and student independent sample t-test was used for comparing differences amongst the variables. A p-value less than 0.05 was considered as statistically significant. Results: Out of 795 subjects, 152 patients (19.12%) were hypertensive, 85 patients (10.69%) were diabetic and 29 patients (3.65%) were hypertensive with diabetic. The prevalence of metabolic syndrome was around 18.11% (144 subjects), out of which 52.78% were female and 47.22% were male. Out of 144 Metabolic Syndrome subjects, 23 subjects were diabetic, 32 were hypertensive, 14 were diabetic with hypertensive and 75 were others. The mean levels of urinary albumin creatinine ratio were increased significantly in metabolic syndrome subjects and the increase in urine Albumin to Creatinine Ratio (uACR) was more in metabolic syndrome subjects having Diabetes and Hypertension both. Conclusion: The present study concluded that the microalbuminuria is associated with metabolic syndrome. The microalbuminuria was found to be more significant in metabolic syndrome subjects who were diabetic with hypertensive as compared to diabetic or hypertensive alone.

scholarly journals Conventional and Genetic Evidence on the Association between Adiposity and CKD

2020 ◽  
Vol 32 (1) ◽  
pp. 127-137 ◽  
Author(s):  
Pengfei Zhu ◽  
William G. Herrington ◽  
Richard Haynes ◽  
Jonathan Emberson ◽  
Martin J. Landray ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Mendelian Randomization ◽  
Underlying Mechanism ◽  
Uk Biobank ◽  
Genetic Associations ◽  
Genetic Analyses ◽  
Waist To Hip Ratio ◽  
Chi Squared ◽  
General Adiposity

BackgroundThe size of any causal contribution of central and general adiposity to CKD risk and the underlying mechanism of mediation are unknown.MethodsData from 281,228 UK Biobank participants were used to estimate the relevance of waist-to-hip ratio and body mass index (BMI) to CKD prevalence. Conventional approaches used logistic regression. Genetic analyses used Mendelian randomization (MR) and data from 394 waist-to-hip ratio and 773 BMI-associated loci. Models assessed the role of known mediators (diabetes mellitus and BP) by adjusting for measured values (conventional analyses) or genetic associations of the selected loci (multivariable MR).ResultsEvidence of CKD was found in 18,034 (6.4%) participants. Each 0.06 higher measured waist-to-hip ratio and each 5-kg/m2 increase in BMI were associated with 69% (odds ratio, 1.69; 95% CI, 1.64 to 1.74) and 58% (1.58; 1.55 to 1.62) higher odds of CKD, respectively. In analogous MR analyses, each 0.06–genetically-predicted higher waist-to-hip ratio was associated with a 29% (1.29; 1.20 to 1.38) increased odds of CKD, and each 5-kg/m2 genetically-predicted higher BMI was associated with a 49% (1.49; 1.39 to 1.59) increased odds. After adjusting for diabetes and measured BP, chi-squared values for associations for waist-to-hip ratio and BMI fell by 56%. In contrast, mediator adjustment using multivariable MR found 83% and 69% reductions in chi-squared values for genetically-predicted waist-to-hip ratio and BMI models, respectively.ConclusionsGenetic analyses suggest that conventional associations between central and general adiposity with CKD are largely causal. However, conventional approaches underestimate mediating roles of diabetes, BP, and their correlates. Genetic approaches suggest these mediators explain most of adiposity-CKD–associated risk.

scholarly journals Correlation between urinary albumin to creatinine ratio and systemic glycocalyx degradation in pediatric sepsis

2018 ◽  
Vol 27 (3) ◽  
pp. 194-200 ◽  
Author(s):  
Rina A.C. Saragih ◽  
Antonius H. Pudjiadi ◽  
Taralan Tambunan ◽  
Hindra I. Satari ◽  
Diana Aulia ◽  
...  
Keyword(s):  
Area Under The Curve ◽  
Correlation Coefficients ◽  
Reference Value ◽  
Pediatric Intensive Care ◽  
Urinary Albumin ◽  
Healthy Children ◽  
Creatinine Ratio ◽  
Cross Sectional ◽  
Cross Sectional Design ◽  
Pediatric Sepsis

Background: Increased capillary permeability in sepsis is associated with several complications and worse outcomes. Glycocalyx degradation, marked by increased serum syndecan-1 levels, alters vascular permeability, which can manifest as albuminuria in the glomerulus. Therefore, elevated urinary albumin to creatinine ratio (ACR) potentially provides an index of systemic glycocalyx degradation. The aim of this study was to analyze the correlation between urinary ACR and serum syndecan-1 levels.Methods: A longitudinal prospective study with repeated cross-sectional design was conducted on children with sepsis in pediatric intensive care unit, we evaluated serum syndecan-1 levels and urinary ACR on days 1, 2, 3, and 7. A descriptive study on healthy children was also conducted to determine the reference value of syndecan-1 in children.Results: 49 subjects with sepsis were recruited. Based on the data of the healthy children group (n=30), syndecan-1 level of >90th percentile (41.42 ng/mL) was defined as systemic glycocalyx degradation. The correlation coefficients (r) between urinary ACR and syndecan-1 levels were 0.32 (p<0.001) from all examination days (162 specimens), 0.298 (p=0.038) on day 1, and 0.469 (p=0.002) on day 3. The area under the curve of urinary ACR and systemic glycocalyx degradation was 65.7% (95% CI 54.5%–77%; p=0.012). Urinary ACR ≥157.5 mg/g was determined as the cut-off point for glycocalyx degradation, with a sensitivity of 77.4% and a specificity of 48%.Conclusion: Urinary ACR showed a weak correlation with systemic glycocalyx degradation, indicating that the pathophysiology of elevated urinary ACR in sepsis is not merely related to glycocalyx degradation.

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