中国10个地区成年人慢性肾脏病流行情况及其生活方式影响因素

王雪; 史可香; 余灿清; 吕筠; 郭彧; 裴培; 夏庆梅; 杜怀东; 陈君石; 陈铮鸣; 李立明; 代表中国慢性病前瞻性研究项目协作组

Abstract

王雪,史可香,余灿清,吕筠,郭彧,裴培,夏庆梅,杜怀东,陈君石,陈铮鸣,李立明,代表中国慢性病前瞻性研究项目协作组.中国10个地区成年人慢性肾脏病流行情况及其生活方式影响因素[J].Chinese journal of Epidemiology,2023,44(3):386-392

中国10个地区成年人慢性肾脏病流行情况及其生活方式影响因素

Prevalence of chronic kidney disease and its association with lifestyle factors in adults from 10 regions of China

Received:August 01, 2022

DOI：10.3760/cma.j.cn112338-20220801-00680

KeyWord: 慢性肾脏病疾病分布生活方式因素前瞻性队列研究

English Key Word: Chronic kidney disease Disease distribution Lifestyle factor Prospective cohort study

FundProject:国家自然科学基金（81941018，91846303，91843302）；国家重点研发计划“精准医学研究”重点专项（2016YFC0900500）；中国香港KadoorieCharitable基金；中央高校基本科研业务费医-X种子基金（BMU2022MX025）

Author Name	Affiliation	E-mail
Wang Xue	Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
Shi Kexiang	Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
Yu Canqing	Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China	yucanqing@pku.edu.cn
Lyu Jun	Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China
Guo Yu	Fuwai Hospital, Chinese Academy of Medical Sciences, National Center for Cardiovascular Diseases, Beijing 100037, China
Pei Pei	Chinese Academy of Medical Sciences, Beijing 100730, China
Xia Qingmei	Chinese Academy of Medical Sciences, Beijing 100730, China
Du Huaidong	Nuffield Department of Population Health, Center for Clinical and Epidemiological Studies, University of Oxford, Oxford OX3 7LF, UK
Chen Junshi	China National Center for Food Safety Risk Assessment, Beijing 100022, China
Chen Zhengming	Nuffield Department of Population Health, Center for Clinical and Epidemiological Studies, University of Oxford, Oxford OX3 7LF, UK
Li Liming	Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing 100191, China
for the China Kadoorie Biobank Collaborative Group

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Abstract:

目的描述中国慢性病前瞻性研究（CKB）项目人群的慢性肾脏病（CKD）分布，分析生活方式与CKD发病风险的前瞻性关联。方法数据来源于CKB基线调查及随访监测（截至2018年12月31日），描述CKD发病的地区和人群分布差异，使用Cox比例风险回归模型分析生活方式因素与CKD的关联。结果研究纳入505 147名研究对象，平均随访11.26年，期间共有4 920例发病病例，发病率为83.43/10万人年，肾小球肾病为最主要亚型。CKD发病率在城市、男性、年龄≥60岁人群中更高，分别为87.83/10万人年、86.37/10万人年、132.06/10万人年。相比于从不或偶尔吸烟者，当前吸烟男性CKD风险增加（HR=1.18，95%CI：1.05~1.31）。以非肥胖人群为参照组，由BMI判定的全身性肥胖（HR=1.19，95%CI：1.10~1.29）和腰围判定的中心性肥胖（HR=1.27，95%CI：1.19~1.35）均与更高的CKD发病风险相关。结论 CKB项目人群CKD发病率存在明显的地区和人群差异，且其发病风险受到生活方式多因素的影响。

English Abstract:

Objective To investigate the distribution of chronic kidney disease (CKD) in participants from the China Kadoorie Biobank (CKB) study and evaluate the association between lifestyle risk factors and CKD. Methods Based on the baseline survey data and follow-up data (as of December 31, 2018) of the CKB study, the differences in CKD cases' area and population distributions were described. Cox proportional hazards regression model was used to estimate the association between lifestyle risk factors and the risk of CKD. Results A total of 505 147 participants, 4 920 cases of CKD were recorded in 11.26 year follow up with a incidence rate of 83.43/100 000 person-years. Glomerulonephropathy was the most common type. The incidence of CKD was higher in the urban area, men, and the elderly aged 60 years and above (87.83/100 000 person-years, 86.37/100 000 person-years, and 132.06/100 000 person-years). Current male smokers had an increased risk for CKD compared with non-smokers or occasional smokers (HR=1.18, 95%CI:1.05-1.31). The non-obese population was used as a control group, both general obesity determined by BMI (HR=1.19, 95%CI:1.10-1.29) and central obesity determined by waist circumference (HR=1.27, 95%CI:1.19-1.35) were associated with higher risk for CKD. Conclusion The risks for CKD varied with area and population in the CKB cohort study, and the risk was influenced by multiple lifestyle factors.

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