非糖尿病慢性肾脏病患者甲状旁腺激素水平与心肾代谢综合征之间的关联
The Association between Parathyroid Hormone Levels and the Cardiorenal Metabolic Syndrome in Non-Diabetic Chronic Kidney Disease.
作者信息
Saab Georges, Whaley-Connell Adam, Bombeck Andrew, Kurella Tamura Manjula, Li Suying, Chen Shu-Cheng, McFarlane Samy I, Sowers James R, Norris Keith, Bakris George L, McCullough Peter A
出版信息
Cardiorenal Med. 2011;1(2):123-130. doi: 10.1159/000327149. Epub 2011 Apr 15.
AIMS
The relationship between parathyroid hormone (PTH) and the cardiorenal metabolic syndrome was examined among non-diabetic persons with chronic kidney disease (CKD).
METHODS
In a cross-sectional analysis, the relationship between PTH levels and the cardiorenal metabolic syndrome was investigated in 3,215 non-diabetic participants in the National Kidney Foundation-Kidney Early Evaluation Program (KEEP 2.0) found to have CKD (eGFR <60 ml/min/1.73 m2).
RESULTS
In unadjusted analyses, the prevalence of the cardiorenal metabolic syndrome increased along increasing PTH quartiles (31.7, 33.8, 37.3, and 48.7%, respectively, p for trend <0.0001). After multivariate adjustment, as compared to the first PTH quartile, odds of the cardiorenal metabolic syndrome were 16% (p = 0.18), 35% (p = 0.006), and 80% (p < 0.0001) higher for the second, third, and fourth quartiles, respectively. When taken as a continuous predictor, each standard deviation increase of natural log transformed PTH was associated with 26% (p < 0.0001) higher odds of the cardiorenal metabolic syndrome. The association of PTH with the cardiorenal metabolic syndrome was not modified by age or gender (p for interaction was not significant for both modifiers).
CONCLUSIONS
Among an outpatient non-diabetic population with CKD, higher PTH levels were associated with a higher prevalence of the cardiorenal metabolic syndrome.
目的
在非糖尿病慢性肾脏病（CKD）患者中研究甲状旁腺激素（PTH）与心肾代谢综合征之间的关系。
方法
在一项横断面分析中，对美国国家肾脏基金会肾脏早期评估项目（KEEP 2.0）中3215名被发现患有CKD（估算肾小球滤过率<60 ml/min/1.73 m²）的非糖尿病参与者，研究PTH水平与心肾代谢综合征之间的关系。
结果
在未经调整的分析中，心肾代谢综合征的患病率随PTH四分位数的增加而升高（分别为31.7%、33.8%、37.3%和48.7%，趋势p<0.0001）。多变量调整后，与第一个PTH四分位数相比，第二、第三和第四个四分位数的心肾代谢综合征的比值比分别高16%（p=0.18）、35%（p=0.006）和80%（p<0.0001）。当将PTH作为连续预测变量时，自然对数转换后的PTH每增加一个标准差，心肾代谢综合征的比值比就高26%（p<0.0001）。PTH与心肾代谢综合征的关联不受年龄或性别的影响（两个调节因素的交互作用p均无统计学意义）。
结论
在门诊非糖尿病CKD患者中，较高的PTH水平与心肾代谢综合征的较高患病率相关。
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