The Second Department of Geriatric Cardiology, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China.
J Geriatr Cardiol. 2012 Jun;9(2):158-65. doi: 10.3724/SP.J.1263.2012.03051.
Both decreased glomerular filtration rate (GFR) and arterial stiffness were considered as risk factors for atherosclerosis. Previous studies have suggested the association between central arterial stiffness and the degree of GFR loss. Whether decreased GFR contributes to peripheral artery stiffness remains controversial. Moreover, data analyzed from a cohort of Chinese women are rare. Our aim was to explore the relationship between GFR and regional arterial stiffness in Chinese women.
In this cross-sectional study, we randomly recruited 1131 adult women residents with GFR ≥ 60 mL/min per 1.73 m(2) estimated by the Chinese Modification of Diet in Renal Disease equation from three large communities. Central and peripheral arterial stiffness were estimated simultaneously by measuring carotid-femoral pulse wave velocity (PWVcf) and carotid-radial PWV (PWVcr) using a validated automatic device. Augmentation Index at heart rate 75 beats/minutes (AIx-75) was measured by pulse wave analysis as a composite parameter reflecting both large and distal arterial properties.
The mean estimated GFR (eGFR) of the study group was 100.05 ± 23.26 mL/minute per 1.73 m(2). Subjects were grouped by tertiles of eGFR level. PWVcf and AIx-75 increased ongoing from the top to the bottom eGFR tertile, while the values of PWVcr were comparable. Both univariate Pearson correlations and multiple stepwise regression analyses showed that eGFR significantly correlated to PWVcf, but not to PWVcr and AIx-75.
In Chinese women with normal to mildly impaired renal function, decreased eGFR affected carotid-to-femoral rather than carotid-to-radial stiffening. This provides rational to conduct future prospective studies to investigate predictors of atherosclerosis in this population.
肾小球滤过率（GFR）降低和动脉僵硬度均被认为是动脉粥样硬化的危险因素。既往研究提示中心动脉僵硬度与 GFR 降低程度相关。GFR 降低是否导致外周动脉僵硬度增加仍存在争议。此外，分析来自中国女性队列的数据较为罕见。本研究旨在探讨中国女性 GFR 与区域性动脉僵硬度的关系。
在这项横断面研究中，我们随机招募了来自三个大型社区的 1131 名估计肾小球滤过率（eGFR）≥60ml/min/1.73m2 的成年女性居民，使用中国改良肾脏病膳食研究方程进行估计。使用经过验证的自动装置同时测量颈股脉搏波速度（PWVcf）和颈桡脉搏波速度（PWVcr）来评估中心和外周动脉僵硬度。通过脉搏波分析测量心率为 75 次/分钟时的增强指数（AIx-75）作为反映大动脉和远端动脉特性的综合参数。
研究组的平均估计肾小球滤过率（eGFR）为 100.05±23.26ml/min/1.73m2。将 eGFR 水平分为三分位数组。PWVcf 和 AIx-75 随着 eGFR 三分位数的从高到低而增加，而 PWVcr 的值则相当。单变量 Pearson 相关分析和多元逐步回归分析均显示 eGFR 与 PWVcf 显著相关，而与 PWVcr 和 AIx-75 不相关。
在肾功能正常至轻度受损的中国女性中，eGFR 降低与颈股动脉僵硬度而非颈桡动脉僵硬度相关。这为进一步开展前瞻性研究以探讨该人群中动脉粥样硬化的预测因素提供了依据。
