Hoy Wendy E, Kondalsamy-Chennakesavan Srinivas, McDonald Stephen, Wang Zhiqiang
Centre for Chronic Disease, Discipline of Medicine, University of Queensland, Royal Brisbane Hospital, Herston 4029, Australia.
Ethn Dis. 2006 Spring;16(2 Suppl 2):S2-46-51.
To describe the association between renal disease and other features of the metabolic syndrome and its derivative illnesses among Australian Aborigines in remote settings.
Volunteering adults (N = 2019) in four remote communities were screened for risk factors and markers of renal disease, hypertension, and diabetes, and their cross-sectional associations were evaluated. Rates of the metabolic syndrome were estimated in one community with comprehensive screening data. The associations of albuminuria with hospitalizations, coronary heart events, and non-renal deaths were then followed for > 7 years in that same community.
Rates of renal disease, hypertension, and diabetes all increased dramatically with age. They all overlapped. Renal disease and hypertension were the most prominent and earliest features of the syndrome, while diabetes was a later, less common and more variable manifestation. All were strongly correlated with waist measurements, and high waist measurements more comprehensively characterized those with illnesses than did the more restrictive definitions of the metabolic syndrome. Albuminuria predicted non-renal hospitalizations, first time coronary heart disease events, and all-cause death.
Albuminuria/proteinuria is an early and dominant element of a symptom complex that is marked by higher waist measurements, and it strongly predicts all-cause and cardiovascular illnesses and deaths. This finding implies a common background of risk factors for renal disease, hypertension, diabetes, and cardiovascular risk. The findings support integrated, rather than disease-specific, surveillance programs, an important role for albuminuria in predicting non-renal risk, and a unified approach for primary and secondary prevention of all elements of the syndrome.
描述偏远地区澳大利亚原住民的肾脏疾病与代谢综合征及其衍生疾病的其他特征之间的关联。
对四个偏远社区的成年志愿者（N = 2019）进行肾脏疾病、高血压和糖尿病的风险因素及标志物筛查，并评估它们的横断面关联。利用一个社区的全面筛查数据估算代谢综合征的发生率。然后在同一社区对蛋白尿与住院、冠心病事件和非肾脏疾病死亡之间的关联进行了7年以上的随访。
肾脏疾病、高血压和糖尿病的发生率均随年龄显著增加。它们相互重叠。肾脏疾病和高血压是该综合征最突出和最早出现的特征，而糖尿病则是较晚出现、较不常见且更具变异性的表现。所有这些都与腰围密切相关，与代谢综合征更严格的定义相比，高腰围更全面地刻画了患病者的特征。蛋白尿可预测非肾脏疾病住院、首次冠心病事件和全因死亡。
蛋白尿/蛋白尿是一种以高腰围为特征的症状复合体的早期和主要成分，它强烈预测全因疾病和心血管疾病及死亡。这一发现意味着肾脏疾病、高血压、糖尿病和心血管疾病风险存在共同的危险因素背景。这些发现支持综合而非针对特定疾病的监测项目，蛋白尿在预测非肾脏疾病风险方面的重要作用，以及对该综合征所有要素进行一级和二级预防的统一方法。
