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轻度慢性肾脏病与老年人动脉僵硬度增加相关。

Mild chronic kidney disease associated with greater risk of arterial stiffness in elderly adults.

机构信息

Department of Family Medicine, National Cheng Kung University Hospital, Tainan, Taiwan.

出版信息

J Am Geriatr Soc. 2013 Oct;61(10):1758-62. doi: 10.1111/jgs.12445. Epub 2013 Sep 19.

Abstract

OBJECTIVES

To assess the association between arterial stiffness and mild and moderate chronic kidney disease (CKD), independent of other cardiometabolic factors in an elderly population.

DESIGN

Cross-sectional study.

SETTING

Health examination data from National Cheng Kung University Hospital from 2006 to 2009.

PARTICIPANTS

Eligible subjects aged 60 and older (N = 1,251).

MEASUREMENTS

An average bilateral brachial-ankle pulse wave velocity (baPWV) of 1,400 cm/s or greater was defined as high baPWV. Based on the 2003 Clinical Practice Guidelines for Chronic Kidney Disease from the National Kidney Foundation, mild and moderate CKD were defined as CKD Stages 1 and 2 and Stages 3 to 5, respectively.

RESULTS

Participants with a baPWV of 1,400 cm/s or greater (n = 1,028) had lower estimated glomerular filtration rates (eGFRs) but higher serum creatinine levels and greater prevalences of mild and moderate CKD, diabetes mellitus, prediabetes mellitus, hypertension, and prehypertension than those with baPWV less than 1,400 cm/s (n = 223). In the multivariate analysis, mild (odds ratio (OR) = 2.58, 95% confidence interval (CI) = 1.02-6.54) and moderate (OR = 3.75, 95% CI = 1.02-13.81) CKD were positively associated with greater baPWV (≥1,400 cm/s). Age, prediabetes mellitus, diabetes mellitus, prehypertension, and hypertension were also independently associated with greater baPWV. In the multiple linear analysis, moderate (β = 120.45, P < .001) and mild CKD (β = 69.90, P = .01) were positively associated with baPWV. There was also an independently inverse correlation between eGFR and baPWV (β = -0.69, P = .04).

CONCLUSION

Mild and moderate CKD increased the risk of greater arterial stiffness in elderly adults. Age, prediabetes mellitus, diabetes mellitus, prehypertension, and hypertension were also important correlates of increased arterial stiffness.

摘要

目的

评估在老年人群中,动脉僵硬与轻度和中度慢性肾脏病(CKD)之间的关联,这种关联独立于其他心血管代谢因素。

设计

横断面研究。

地点

2006 年至 2009 年来自国立成功大学医院的健康检查数据。

参与者

年龄在 60 岁及以上的合格受试者(N=1251)。

测量方法

平均双侧肱踝脉搏波速度(baPWV)≥1400cm/s 定义为高 baPWV。根据 2003 年美国国家肾脏基金会的慢性肾脏病临床实践指南,轻度和中度 CKD 分别定义为 CKD 阶段 1 和 2 以及阶段 3 至 5。

结果

baPWV≥1400cm/s(n=1028)的参与者估算肾小球滤过率(eGFR)较低,但血清肌酐水平较高,且轻度和中度 CKD、糖尿病、糖尿病前期、高血压和高血压前期的患病率较高,而 baPWV<1400cm/s(n=223)的参与者。在多变量分析中,轻度(比值比(OR)=2.58,95%置信区间(CI)=1.02-6.54)和中度(OR=3.75,95%CI=1.02-13.81)CKD 与较大的 baPWV(≥1400cm/s)呈正相关。年龄、糖尿病前期、糖尿病、高血压前期和高血压也与较大的 baPWV 独立相关。在多元线性分析中,中度(β=120.45,P<.001)和轻度 CKD(β=69.90,P=.01)与 baPWV 呈正相关。eGFR 与 baPWV 之间也存在独立的负相关关系(β=-0.69,P=.04)。

结论

轻度和中度 CKD 增加了老年人群动脉僵硬程度增加的风险。年龄、糖尿病前期、糖尿病、高血压前期和高血压也是动脉僵硬增加的重要相关因素。

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