The association between serum activin A levels and albuminuria among community-dwelling middle-aged and older adults in Taiwan

• Main Authors: Shih-Chen Chang, Chien-Yi Hsu, Li-Kuo Liu, Ya-Wen Lu, Yi-Lin Tsai, Ruey-Hsing Chou, Po-Hsun Huang, Liang-Kung Chen, Shing-Jong Lin
• Format: Article
• Language: English
• Published: Nature Publishing Group 2021-10-01
• Series: Scientific Reports
• Online Access: https://doi.org/10.1038/s41598-021-99081-7

Abstract Activin A, a cytokine belonging to the transforming growth factor-β family, has been shown to play pivotal roles in tissue remodeling after renal injury and is present in elevated levels in diabetic patients. However, the association between activin A and albuminuria remains unclear. We aimed to evaluate their association by using cross-sectional data from community-dwelling middle-aged and older adults in Taiwan. We assessed 466 participants (67% male; mean age 71 ± 13 years) from the I-Lan Longitudinal Aging study for whom data pertaining to serum activin A level and urine albumin-to-creatinine ratio (UACR) were available. Of these, 323 (69%) had normal albuminuria, 123 (26%) had microalbuminuria, and 20 (4%) had overt albuminuria. Patients with overt albuminuria and microalbuminuria had significantly higher activin A concentrations than those in the normal albuminuria group (p < 0.001). Circulating activin A was significantly correlated with multiple risk factors, including higher systolic blood pressure and higher UACR. Univariate and multivariate results indicated that activin A level was an independent variable for albuminuria. The cutoff value of 602 pg/mL of activin A demonstrated a sensitivity of 70.6% and specificity of 75.7% (AUC 0.774) in diagnosing overt albuminuria. In conclusion, middle-aged and older adults with elevated activin A levels were associated with a higher incidence of albuminuria.