| 宋慧,丁伟洁,卓朗,汪秀英,黄水平.肾小球滤过率异常与代谢综合征相关性分层分析[J].中华流行病学杂志,2014,35(5):593-596 |
| 肾小球滤过率异常与代谢综合征相关性分层分析 |
| Association between the glomerular filtration rate of renal dysfunction and metabolic syndrome：an age-stratified analysis |
| 收稿日期:2013-10-17 出版日期:2014-09-17 |
| DOI：10.3760/cma.j.issn.0254-6450.2014.05.028 |
| 中文关键词: 估计肾小球滤过率 代谢综合征 肾功能不全 危险因素 分层分析 |
| 英文关键词: Estimated glomerular filtration rate Metabolic syndrome Renal dysfunction Risk factors Stratified analysis |
| 基金项目:江苏省普通高校研究生科研创新计划（CXLX13_998）；徐州市科技项目（XZZD1239）；江苏省社科研究重点课题（13SQB-058） |
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| 中文摘要: |
| 目的 分析不同年龄组人群肾小球滤过率（GFR）异常与MS的相互关系。方法 选择2010年3月至2012年9月徐州市某三级甲等医院健康体检资料，以MDRD公式的估计GFR（eGFR）作为肾脏损伤指标，与样本MS组分按年龄分层进行分析。结果 75 469例合格样本中，eGFR 异常率为 0.47%，青年、中年、老年组 eGFR 异常率依次为 0.05%、0.20%、1.68%（P<0.05）；MS 组与非 MS 组 eGFR 异常率仅在老年组的差异有统计学意义（P<0.05）。在年龄组与 MS 组分数分层分析中，仅中年组在2个MS组分、老年组在3个和5个MS组分中，eGFR异常率的差异有统计学意义（P<0.05），其他各年龄组eGFR异常率与MS组分数趋势χ2检验均无统计学意义（P>0.05）。按 MS 组分分层后，青年组和中年组血压升高可增加 eGFR 异常率，中年组和老年组HDL-C 水平下降可增加 eGFR 异常率，老年组 FPG 升高可增加 eGFR 异常率（P<0.05），各年龄组TG 水平升高和肥胖对 eGFR 异常率的差异均无统计学意义（P>0.05）。青年组血压升高对 eGFR异常率归因危险度百分比（PAR%）最高（41.91%）。结论 徐州地区健康体检者eGFR异常率较低，各年龄组eGFR异常率与MS组分数增加无关，但与特定的MS组分相关，血压升高表现为近期和中期效应、HDL-C下降表现为中远期效应、FPG升高表现为远期效应，而TG水平升高与肥胖未见效应，PAR%结果显示血压升高仍然是eGFR异常的最大危险因素。 |
| 英文摘要: |
| Objective To explore the relationship between the renal dysfunction rate and metabolic syndrome (MS), stratified by age. Methods People took part in physical check-up in a certain tertiary hospital from March 2010 to September 2012，were enrolled in this study. Estimated glomerular filtration rate（eGFR), a renal dysfunction indicator, was calculated by modified MDRD equation［<60 ml/min（1.73 m2)]. Associations between the renal dysfunction rate and factors as age，gender and MS traits，were assessed by stratified analysis. Results Eligible data from 75 469 subjects were used. The prevalence rates of renal dysfunctions appeared to be 0.05%，0.20%，1.68% in 18 to 44 year-olds（youth), 45 to 59 year-olds（middle）and 60 year-olds or above (old), respectively.Participants with MS showed a significantly higher risk than those without，in the elderly only（P<0.05）but not in the other 2 groups（P>0.05). Participants with 2 components of MS in middle-aged，3 or 5 components of MS in the elderly showed a significantly high incidence（P<0.05), but no significant differences seen in other subgroups（P>0.05). Increasing trend was not seen in all the 3groups（P>0.05). Elevated blood pressure（BP＋）in youth and middle-aged groups，decreased high density lipoprotein（HDL-C）in middle-aged and elderly groups and elevated fasting plasma glucose（FPG＋）in elderly group could all cause the abnormality rate of eGFR which showed significantly high incidence rates in the subgroup analysis（P<0.05).The maximum of population attributable risk proportion （PAR%） was 41.91% in youth when having elevated BP. Relationship between renal dysfunction rate and triglyeride（TG)/obesity was not identified. Conclusion The prevalence of renal dysfunction was found low, in Xuzhou. The incidence was not associated with the numbers but might relate to the nature of certain components of MS. Increased BP showed both short-term and mid-term effects. Decreased HDL-C，however，indicated both mid-term and long-term effects. The elevated FPG only appeared long-term effects. Increased TG and obesity did not show significant effects in these observed samples. PAR% of increased BP seemed to be the most important factors which might lead to renal dysfunction. |
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