Iguchi Yasuyuki, Kimura Kazumi, Kobayashi Kazuto, Aoki Junya, Terasawa Yuka, Sakai Kenichiro, Uemura Junichi, Shibazaki Kensaku
Department of Stroke Medicine, Kawasaki Medical School, Kurashiki City, Okayama, Japan.
Am J Cardiol. 2008 Oct 15;102(8):1056-9. doi: 10.1016/j.amjcard.2008.06.018. Epub 2008 Jul 26.
Although both atrial fibrillation (AF) and decreasing glomerular filtration rate (GFR) are strongly related to advanced age and share common associated vascular risk factors, few studies have explored the relation between AF and GFR. From residents (age >or=40 years) in Kurashiki City, a total of 41,417 subjects (median age 72 years; 13,956 men) were enrolled in the Kurashiki City Annual Medical Survey from May to December 2006. The estimated overall prevalence of AF was 1.6% (2.8% in the low-GFR tertile, 1.2% in the middle tertile, and 0.9% in the high tertile, p <0.001). After all subjects were categorized into age tertiles (age thresholds 68 and 76 years), AF was identified in 0.9% in the low-GFR tertile, 0.6% in the middle tertile, and 0.5% in the high tertile in the low-age tertile (p = 0.018); 2.6% in the low-GFR tertile, 1.2% in the middle tertile, and 1.1% in the high tertile in the middle-age tertile (p <0.001); and 3.9% in the low-GFR tertile, 2.4% in the middle tertile, and 1.7% in the high tertile in the high-age tertile (p <0.001). The odds ratio for AF adjusted for age, gender, vascular risk factors, cardiac disease, and hemoglobin was 1.91 (95% confidence interval 1.54 to 2.38, p <0.001) for the low-GFR tertile versus the high tertile and 1.12 (95% confidence interval 0.88 to 1.42, p = 0.364) for the middle-GFR tertile versus the high tertile. The prevalence of AF gradually increased with decreasing GFR. In conclusion, AF appears to be associated with decreasing GFR.
虽然心房颤动（AF）和肾小球滤过率（GFR）降低均与高龄密切相关，且具有共同的相关血管危险因素，但很少有研究探讨AF与GFR之间的关系。在仓敷市年龄≥40岁的居民中，共有41417名受试者（年龄中位数72岁；男性13956名）纳入了2006年5月至12月的仓敷市年度医学调查。AF的总体估计患病率为1.6%（低GFR三分位数组为2.8%，中三分位数组为1.2%，高三分位数组为0.9%，p<0.001）。在将所有受试者按年龄三分位数（年龄阈值为68岁和76岁）分类后，低年龄三分位数组中，低GFR三分位数组的AF患病率为0.9%，中三分位数组为0.6%，高三分位数组为0.5%（p = 0.018）；中年年龄三分位数组中，低GFR三分位数组为2.6%，中三分位数组为1.2%，高三分位数组为1.1%（p<0.001）；高年龄三分位数组中，低GFR三分位数组为3.9%，中三分位数组为2.4%，高三分位数组为1.7%（p<0.001）。经年龄、性别、血管危险因素、心脏病和血红蛋白校正后，低GFR三分位数组与高三分位数组相比，AF的比值比为1.91（95%置信区间1.54至2.38，p<0.001），中GFR三分位数组与高三分位数组相比为1.12（95%置信区间0.88至1.42，p = 0.364）。AF的患病率随GFR降低而逐渐升高。总之，AF似乎与GFR降低有关。
