Division of Nephrology, National Hospital Organization Chiba-East Hospital, 673 Nitona-cho, Chuoh-ku, Chiba, Chiba 260-8712, Japan.
Clin Exp Nephrol. 2012 Aug;16(4):617-21. doi: 10.1007/s10157-012-0607-5. Epub 2012 Feb 23.
An ecological study is a useful epidemiologic tool for public health surveillance and establishment of a new hypothesis. Here, we used an ecological study to analyze the association between birth weight and end-stage renal disease (ESRD).
We performed ecological regression analysis by using data obtained from the national database of Japan. The data include regional incidence of ESRD beginning maintenance dialysis therapy, regional rate of low-birth weight (LBW) newborn babies of all newborn babies, the average birth weight of newborns, the body mass index (BMI) score, the prevalence of diabetes mellitus, and the amount of payment for drugs, in the 47 prefectures of Japan.
The mean regional rates of LBW newborn babies from 1999 to 2008 statistically correlated with the mean incidences of ESRD during the same time periods in each prefecture. The correlation coefficients between the yearly rate of LBW newborns and the yearly incidence of ESRD in each prefecture became higher after statistically considering the effects of the cost per resident for prescriptions of angiotensin II receptor blocker and angiotensin converting enzyme inhibitor. Furthermore, the final model predicting the regional incidence of ESRD by a stepwise multiple regression analysis consisted of the average BMI score and the rate of LBW newborns in each prefecture.
Although this study cannot explain the reason for this unexpected correlation between the regional rate of LBW babies and the regional incidence of ESRD at the same time points, the statistically significant correlations shown in this study should be taken into consideration.
生态研究是公共卫生监测和建立新假设的有用流行病学工具。在这里,我们使用生态研究来分析出生体重与终末期肾病(ESRD)之间的关系。
我们通过使用从日本国家数据库中获得的数据进行生态回归分析。这些数据包括日本 47 个县开始维持透析治疗的 ESRD 区域发病率、所有新生儿中低出生体重(LBW)新生儿的区域比率、新生儿的平均出生体重、体重指数(BMI)评分、糖尿病患病率以及药物费用。
1999 年至 2008 年期间,LBW 新生儿的平均区域比率与每个县同期 ESRD 的平均发生率呈统计学相关。在统计学上考虑了每个县的居民处方血管紧张素 II 受体阻滞剂和血管紧张素转换酶抑制剂的费用后,LBW 新生儿的年发生率与每个县的 ESRD 年发生率之间的相关系数更高。此外,逐步多元回归分析预测 ESRD 区域发生率的最终模型由每个县的平均 BMI 评分和 LBW 新生儿的比率组成。
尽管这项研究不能解释同时点 LBW 婴儿的区域比率与 ESRD 的区域发生率之间这种意外关联的原因,但本研究显示的统计学显著相关性应予以考虑。