Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA.
Clin J Am Soc Nephrol. 2011 Sep;6(9):2121-31. doi: 10.2215/CJN.11341210.
Hispanics are the largest minority group in the United States. The leading cause of death in patients with chronic kidney disease (CKD) is cardiovascular disease (CVD), yet little is known about its prevalence among Hispanics with CKD.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted cross-sectional analyses of prevalent self-reported clinical and subclinical measures of CVD among 497 Hispanics, 1638 non-Hispanic Caucasians, and 1650 non-Hispanic African Americans, aged 21 to 74 years, with mild-to-moderate CKD at enrollment in the Chronic Renal Insufficiency Cohort (CRIC) and Hispanic CRIC (HCRIC) studies. Measures of subclinical CVD included left ventricular hypertrophy (LVH), coronary artery calcification (CAC), and ankle-brachial index.
Self-reported coronary heart disease (CHD) was lower in Hispanics compared with non-Hispanic Caucasians (18% versus 23%, P = 0.02). Compared with non-Hispanic Caucasians, Hispanics had a lower prevalence of CAC >100 (41% versus 34%, P = 0.03) and CAC >400 (26% versus 19%, P = 0.02). However, after adjusting for sociodemographic factors, these differences were no longer significant. In adjusted analyses, Hispanics had a higher odds of LVH compared with non-Hispanic Caucasians (odds ratio 1.97, 95% confidence interval, 1.22 to 3.17, P = 0.005), and a higher odds of CAC >400 compared with non-Hispanic African Americans (odds ratio, 2.49, 95% confidence interval, 1.11 to 5.58, P = 0.03). Hispanic ethnicity was not independently associated with any other CVD measures.
Prevalent LVH was more common among Hispanics than non-Hispanic Caucasians, and elevated CAC score was more common among Hispanics than non-Hispanic African Americans. Understanding reasons for these racial/ethnic differences and their association with long-term clinical outcomes is needed.
西班牙裔是美国最大的少数族裔群体。在慢性肾脏病（CKD）患者中，心血管疾病（CVD）是导致死亡的主要原因，但目前对 CKD 西班牙裔患者 CVD 的患病率知之甚少。
设计、设置、参与者和测量方法：我们对慢性肾功能不全队列（CRIC）和西班牙裔 CRIC（HCRIC）研究中 497 名西班牙裔、1638 名非西班牙裔白人和 1650 名非西班牙裔非裔美国人的临床和亚临床 CVD 指标进行了横断面分析，这些患者年龄在 21 至 74 岁之间，存在轻至中度 CKD。亚临床 CVD 的测量指标包括左心室肥厚（LVH）、冠状动脉钙化（CAC）和踝臂指数。
与非西班牙裔白种人相比，西班牙裔报告的冠心病（CHD）较低（18%比 23%，P=0.02）。与非西班牙裔白种人相比，西班牙裔 CAC>100（41%比 34%，P=0.03）和 CAC>400（26%比 19%，P=0.02）的患病率较低。然而，在调整了社会人口因素后，这些差异不再显著。在调整后的分析中，与非西班牙裔白种人相比，西班牙裔发生 LVH 的几率更高（比值比 1.97，95%置信区间，1.22 至 3.17，P=0.005），发生 CAC>400 的几率也更高（比值比，2.49，95%置信区间，1.11 至 5.58，P=0.03）。西班牙裔种族与任何其他 CVD 测量指标均无独立相关性。
西班牙裔人群中常见的 LVH 比非西班牙裔白种人更为常见，而 CAC 评分升高的情况在西班牙裔人群中比非西班牙裔非裔美国人更为常见。了解这些种族/民族差异的原因及其与长期临床结局的关系是必要的。
