1 The Faculty of Medicine, Aalborg University, VBN2 Department of Clinical Medicine, The Faculty of Medicine, Aalborg University, VBN3 Research Centre for Prevention and Health, Glostrup University Hospital, Glostrup, Denmark.4 Section of Metabolic Genetics, University of Copenhagen, Copenhagen, Denmark.5 Steno Diabetes Center, Gentofte, Denmark; University of Copenhagen, Copenhagen, Denmark; University of Aarhus, Aarhus, Denmark.6 Department of Health Science and Technology, The Faculty of Medicine, Aalborg University, VBN7 Department of Medicine, Roskilde University Hospital, Roskilde, Denmark.8 Research Centre for Prevention and Health, Glostrup University Hospital, Glostrup, Denmark; Department of Clinical Experimental Research, Glostrup University Hospital, Glostrup, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
BACKGROUND: Urine albumin creatinine ratio, UACR, is positively associated with all-cause mortality, cardiovascular disease and diabetes in observational studies. Whether a high UACR is also associated with other causes of death is unclear. We investigated the association between UACR and cause-specific mortality. METHODS: We included a total of 9,125 individuals from two population-based studies, Monica10 and Inter99, conducted in 1993-94 and 1999-2001, respectively. Urine albumin creatinine ratio was measured from spot urine samples by standard methods. Information on causes of death was obtained from The Danish Register of Causes of Death until 31 December 2010. There were a total of 920 deaths, and the median follow-up was 11.3 years. RESULTS: Multivariable Cox regression analyses with age as underlying time axis showed statistically significant positive associations between UACR status and risk of all-cause mortality, endocrine nutritional and metabolic diseases, mental and behavioural disorders, diseases of the circulatory system, and diseases of the respiratory system with hazard ratios 1.56, 6.98, 2.34, 2.03, and 1.91, for the fourth UACR compared with the first, respectively. Using UACR as a continuous variable, we also found a statistically significant positive association with risk of death caused by diseases of the digestive system with a hazard ratio of 1.02 per 10 mg/g higher UACR. CONCLUSION: We found statistically significant positive associations between baseline UACR and death from all-cause mortality, endocrine nutritional and metabolic diseases, and diseases of the circulatory system and possibly mental and behavioural disorders, and diseases of the respiratory and digestive system.