Tianjin Medical Journal ›› 2015, Vol. 43 ›› Issue (7): 777-781.doi: 10.11958/j.issn.0253-9896.2015.07.021

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Diagnostic value of random spot urine albumin/creatinine ratio in women with hypertensivedisorders complicating pregnancy

YIN Hong, ZHONG Mei   

  1. 1Department of Obstetrics, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 
    2 Department of Obstetrics, Xiaolan Hospital, Southern Medical University



  • Received:2015-02-02 Revised:2015-04-29 Published:2015-07-15 Online:2015-07-15
  • Contact: ZHONG Mei1 E-mail:zhongmei@fimmu.com
  • Supported by:
    Diagnostic value of random spot albuminuria to creatinine ratio and urine protein quantitative in women with hypertensive disorders complicating pregnancy

Abstract: Objective Determined random spot albuminuria to creatinine ratio(ACR) ,24 hours urinary protein and other biochemical indicators. Other biochemical indicators, analyzed the correlation of them, to discuss the diagnostic value of ACR in women with hypertensive disorders complicating pregnancy. Methods 584 women with hypertensive disorders complicating pregnancy including 169 gestational hypertension, 205 mild preeclampsia, 173 severe preeclampsia, 37 chronic hypertension complicating pregnancy and 2038 normal pregnant women were collected over the same time. ACR, 24 hours urinary protein, routine examination of blood and urine, coagulative function, liver and kidney function, fasting plasma glucose, glycated hemoglobin, insulin, C-Peptide, lipids were determined and compared in all the cases. Bivariate correlation analysis was used to analyze the relationship of ACR, 24 hours urinary protein quantitative and other biochemical indicators. To identify the independent risk factor of hypertensive disorders complicating pregnancy on logistic regression analysis. Receiver operating characteristic (ROC) curve was used to analyze the sensitivity, specificity and optimal cut off value of ACR for predicting hypertensive disorders complicating pregnancy. Results (1)ACR, 24 hours urinary protein quantitative, blood urea nitrogen, serum creatinine, uric acid, total cholesterol, low density lipoprotein cholesterol (BUN, Cr, UA, TC, LDL) were significantly higher in women with severe preeclampsia, however, platelet (PLT), serum albumin, total protein were significantly lower. In women with mild preeclampsia group, ACR, 24 hours urinary protein quantitative, UA was significantly higher, while serum albumin significantly lower than that in the other two groups.(2)There were positive correlation between the ACR and 24 hours urinary protein quantitative, urea nitrogen, serum creatinine, UA, D-dimer, TC, LDL (r=0.94, 0.37, 0.35, 0.61, 0.12, 0.33, 0.31, p<0.05 ), while negative correlation between ACR and serum albumin, total protein, PLT (r=-0.46, -0.40, -0.12, p<0.05 ) (3)Area under curve (AUC), sensitivity, specificity and optimal cut off value of ACR for predicting gestational hypertension, mild preeclampsia, severe preeclampsia ( 24 hours urinary protein quantitative≥2g) severe preeclampsia ( 24 hours urinary protein quantitative≥5g) were 0.823, 0.89, 0.61, 1.44mg/mmol, 0.988, 0.97, 0.96, 10.48 mg/mmol, 0.978, 0.97, 0.88, 39.84 mg/mmol, 0.973, 0.95, 0.87, 94.91 mg/mmol separately. Conclusions There was positive correlation between ACR and 24 hours urinary protein quantitative. ACR could be used for diagnosing and estimating the severity degree of hypertensive disorders complicating pregnancy.

Key words: hypertension, pregnancy complications, cardiovascular, urinary albumin, creatinine, urinalysis, diagnostic
techniques, obstetrical and gynecological