{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T22:55:11Z","timestamp":1789599311894,"version":"build-2803163510"},"reference-count":71,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2019,2,1]],"date-time":"2019-02-01T00:00:00Z","timestamp":1548979200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>Chronic lower respiratory diseases (CLRDs), including chronic obstructive pulmonary disease (COPD) and asthma, are the fourth leading cause of death. Prior studies suggest that albuminuria, a biomarker of endothelial injury, is increased in patients with COPD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To test whether albuminuria was associated with lung function decline and incident CLRDs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Six U.S. population\u2013based cohorts were harmonized and pooled. Participants with prevalent clinical lung disease were excluded. Albuminuria (urine albumin-to-creatinine ratio) was measured in spot samples. Lung function was assessed by spirometry. Incident CLRD-related hospitalizations and deaths were classified via adjudication and\/or administrative criteria. Mixed and proportional hazards models were used to test individual-level associations adjusted for age, height, weight, sex, race\/ethnicity, education, birth year, cohort, smoking status, pack-years of smoking, renal function, hypertension, diabetes, and medications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>Among 10,961 participants with preserved lung function, mean age at albuminuria measurement was 60 years, 51% were never-smokers, median albuminuria was 5.6 mg\/g, and mean FEV1 decline was 31.5 ml\/yr. For each SD increase in log-transformed albuminuria, there was 2.81% greater FEV1 decline (95% confidence interval [CI], 0.86\u20134.76%; P\u2009=\u20090.0047), 11.02% greater FEV1\/FVC decline (95% CI, 4.43\u201317.62%; P\u2009=\u20090.0011), and 15% increased hazard of incident spirometry-defined moderate-to-severe COPD (95% CI, 2\u201331%, P\u2009=\u20090.0021). Each SD log-transformed albuminuria increased hazards of incident COPD-related hospitalization\/mortality by 26% (95% CI, 18\u201334%, P\u2009&amp;lt;\u20090.0001) among 14,213 participants followed for events. Asthma events were not significantly associated. Associations persisted in participants without current smoking, diabetes, hypertension, or cardiovascular disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Albuminuria was associated with greater lung function decline, incident spirometry-defined COPD, and incident COPD-related events in a U.S. population\u2013based sample.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1164\/rccm.201803-0402oc","type":"journal-article","created":{"date-parts":[[2018,9,28]],"date-time":"2018-09-28T03:03:07Z","timestamp":1538103787000},"page":"321-332","source":"Crossref","is-referenced-by-count":39,"title":["Albuminuria, Lung Function Decline, and Risk of Incident Chronic Obstructive Pulmonary Disease. The NHLBI Pooled Cohorts Study"],"prefix":"10.1093","volume":"199","author":[{"given":"Elizabeth C.","family":"Oelsner","sequence":"first","affiliation":[{"name":"Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pallavi P.","family":"Balte","sequence":"additional","affiliation":[{"name":"Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morgan E.","family":"Grams","sequence":"additional","affiliation":[{"name":"Department of Medicine, Johns Hopkins University, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia A.","family":"Cassano","sequence":"additional","affiliation":[{"name":"Division of Nutritional Sciences, College of Human Ecology, Cornell University, Cornell, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David R.","family":"Jacobs","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Community Health and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. 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