JACC. Asia
August 12, 2026 · via Europe PMC
Lifestyle and Metabolic Health, Low-Grade to Clinically Elevated Albuminuria, and Cardiovascular-Renal Diseases.
Ding Y, Cao Q, Wu X, +44 more, Bi Y.
AI summary — for doctors, generated from the abstract only
Even mildly raised urinary albumin, at 10 mg/g or above, is linked to higher cardiovascular and kidney risk, and healthy lifestyle and metabolic control seem to blunt that risk.
What was studied
Cohort analysis of 82,509 adults in the Chinese 4C study with median 3.0 years follow-up, examining how lifestyle and metabolic factors modify the link between UACR levels and incident cardiovascular disease and CKD.
Key findings
- UACR of 10 mg/g or higher already conferred excess risk
- The pattern was mirrored by worse PREVENT score and eGFR
- Optimal lifestyle and metabolic status generally attenuated CVD risk tied to low-grade albuminuria
- Improving metabolic status lowered CVD and cardiorenal risk even in clinically elevated albuminuria
Clinical relevance
Albuminuria in the low-grade range is often dismissed as normal. It may flag patients for earlier preventive attention across cardiology, nephrology and primary care.
Who should care
Limitations
Follow-up was short (median 3.0 years) and observational, so residual confounding and reverse causation cannot be excluded.
Low-grade albuminuria might be treated as an early prompt for risk-factor review rather than as a reassuring result.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Background
Albuminuria from low-grade to clinically elevated range confers cardiorenal risks.
Objectives
The authors aimed to investigate the differential roles of lifestyle/metabolic factors in the association of fine-categorized and continuously measured urinary albumin-to-creatinine ratio (UACR) levels with cardiorenal outcomes.
Methods
A total of 82,509 participants from the China Cardiometabolic Disease and Cancer Cohort (4C) Study were included, with a median follow-up of 3.0 years. Outcomes included incident cardiovascular disease (CVD), incident CKD, their composite, along with surrogate markers. Lifestyle factors included tobacco use, alcohol use, diet, physical activity and sleep. Metabolic factors included diabetes, hypertension, abdominal obesity, and elevated low-density lipoprotein cholesterol. Cox proportional hazard models were used to calculate hazard ratios.
Results
Compared to the lowest UACR, participants with mildly elevated UACR (≥10 to nonlinearity = 0.0009), with UACR ≥10 mg/g already conferring risks, a pattern also reflected by the deterioration of PREVENT score and estimated glomerular filtration rate. Optimal lifestyle and metabolic status generally attenuated CVD risk related to low-grade albuminuria, while improvement of the latter additionally decreased CVD and cardiorenal risk, even in clinically elevated albuminuria (additive Pinteraction <0.0001). Hypertension showed the largest relative contribution to cardiorenal risk, particularly in UACR <30 mg/g.
Conclusions
Our findings highlighted low-grade albuminuria as a key preventive window for cardiorenal outcomes requiring both aspects of modifiable risk factors, and the cardiovascular benefits of metabolic improvement in established albuminuria.
DOI
10.1016/j.jacasi.2026.06.032
PMID
42584389
PMCID
PMC13654428
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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