肾功能、心血管疾病危险因素的流行率和 5 年疾病发病率；饮食、运动、血脂和炎症标志物的作用：ATTICA 研究。

Renal function, cardiovascular disease risk factors' prevalence and 5-year disease incidence; the role of diet, exercise, lipids and inflammation markers: the ATTICA study.

机构信息

First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece.

出版信息

QJM. 2010 Jun;103(6):413-22. doi: 10.1093/qjmed/hcq045. Epub 2010 Apr 7.

DOI:10.1093/qjmed/hcq045

PMID:20375102

Abstract

BACKGROUND

We aimed to evaluate the association between renal function and various cardiovascular disease (CVD) risk factors, as well as 5-year incidence of CVD, in a sample of CVD free adults.

METHODS

(i) Cross-sectional information from n = 1975. Greek men and women (>18 years) without CVD and hypertension at baseline examination and (ii) 5-year (2001-06) survival data from n = 2101 individuals without CVD at baseline, all participants in the ATTICA study, were analysed in this work. Kidney function was quantified by the baseline estimated creatinine clearance rate (C(cr)), using the Cockcroft-Gault formula and the National Kidney Foundation recommendations. Outcome of interest was the development of CVD that was defined according to WHO-ICD-10 criteria.

RESULTS

At baseline, the prevalence of moderate-to-severe renal dysfunction (i.e. C(cr) < 60) was 2.8% in males and 7.7% in females. Physical activity status, cigarette smoking, hypercholesterolemia and homocysteine levels and greater adherence to the Mediterranean diet were inversely associated with C(cr) rate (P < 0.05), while no association was found with history of diabetes. During the 5-year follow-up, people with moderate-to-severe renal dysfunction as compared with normal, had 3.21 times higher CVD risk [95% confidence interval (CI) 1.98-5.19], after adjusting for history of hypertension (hazard ratio = 2.15, 95% CI 1.48-3.11), hypercholesterolemia (1.37, 0.98-1.98), diabetes (3.28, 2.15-5.00), smoking habits (0.89, 0.60-1.32) and physical activity status (0.86, 0.56-1.21).

CONCLUSION

Renal function seems to be associated with the levels of lifestyle and bio-clinical CVD risk factors and contribute to the long-term incidence of cardiac events. Public health care practitioners should take into account renal function in better preventing the burden of CVD at individual, and population level, as well.

摘要

背景

本研究旨在评估肾功能与各种心血管疾病（CVD）危险因素之间的关系，以及 CVD 无患者的 5 年 CVD 发生率。

方法

（i）纳入 n = 1975 名无 CVD 和高血压的希腊男性和女性（≥18 岁），在基线检查时进行横断面信息收集；（ii）纳入 n = 2101 名无 CVD 的个体，在基线时进行 5 年（2001-06 年）生存数据收集，所有参与者均来自 ATTICA 研究。采用 Cockcroft-Gault 公式和美国国家肾脏基金会的建议，根据基线估算的肌酐清除率（C(cr)）定量评估肾脏功能。研究的主要终点是根据世界卫生组织-国际疾病分类第 10 版（WHO-ICD-10）标准定义的 CVD 发展情况。

结果

在基线时，男性中中度至重度肾功能障碍（即 C(cr) < 60）的患病率为 2.8%，女性为 7.7%。身体活动状况、吸烟、高胆固醇血症和同型半胱氨酸水平以及对地中海饮食的更高依从性与 C(cr)率呈负相关（P < 0.05），而与糖尿病史无关联。在 5 年随访期间，与肾功能正常者相比，中度至重度肾功能障碍者的 CVD 风险增加了 3.21 倍[95%置信区间（CI）1.98-5.19]，调整高血压史（危险比=2.15，95%CI 1.48-3.11）、高胆固醇血症（1.37，0.98-1.98）、糖尿病（3.28，2.15-5.00）、吸烟习惯（0.89，0.60-1.32）和身体活动状况（0.86，0.56-1.21）后。