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在非糖尿病的普通人群中,亚临床心血管疾病与肾小球滤过率高有关。

Subclinical cardiovascular disease is associated with a high glomerular filtration rate in the nondiabetic general population.

机构信息

1] Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway [2] Section of Nephrology, University Hospital of North Norway, Tromsø, Norway [3] Department of Clinical Research, University Hospital of North Norway, Tromsø, Norway.

Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway.

出版信息

Kidney Int. 2014 Jul;86(1):146-53. doi: 10.1038/ki.2013.470. Epub 2013 Dec 4.

Abstract

A reduced glomerular filtration rate (GFR) in chronic kidney disease is a risk factor for cardiovascular disease. However, evidence indicates that a high GFR may also be a cardiovascular risk factor. This issue remains unresolved due to a lack of longitudinal studies of manifest cardiovascular disease with precise GFR measurements. Here, we performed a cross-sectional study of the relationship between high GFR measured as iohexol clearance and subclinical cardiovascular disease in the Renal Iohexol Clearance Survey in Tromsø 6 (RENIS-T6), a representative sample of the middle-aged general population. A total of 1521 persons without cardiovascular disease, chronic kidney disease, diabetes, or micro- or macroalbuminuria were examined with carotid ultrasonography and electrocardiography. The GFR in the highest quartile was associated with an increased odds ratio of having total carotid plaque area greater than the median of non-zero values (odds ratio 1.56, 95% confidence interval 1.02-2.39) or electrocardiographic signs of left ventricular hypertrophy (odds ratio 1.62, 95% confidence interval 1.10-2.38) compared to the lowest quartile. The analyses were adjusted for cardiovascular risk factors, urinary albumin excretion, and fasting serum glucose. Thus, high GFR is associated with carotid atherosclerosis and left ventricular hypertrophy and should be investigated as a possible risk factor for manifest cardiovascular disease in longitudinal studies.

摘要

肾小球滤过率(GFR)降低是慢性肾脏病患者发生心血管疾病的一个危险因素。然而,有证据表明,高 GFR 也可能是心血管疾病的一个危险因素。由于缺乏对有明确 GFR 测量的显性心血管疾病的纵向研究,这个问题仍然没有得到解决。在这里,我们对特罗姆瑟 6 号(RENIS-T6)肾碘海醇清除率调查中的高 GFR(通过碘海醇清除率测量)与亚临床心血管疾病之间的关系进行了横断面研究,该研究是中年普通人群的代表性样本。共有 1521 名无心血管疾病、慢性肾脏病、糖尿病或微量或大量白蛋白尿的患者接受了颈动脉超声和心电图检查。与最低四分位数相比,最高四分位数的 GFR 与总颈动脉斑块面积大于非零值中位数的比值增加有关(比值 1.56,95%置信区间 1.02-2.39)或心电图左心室肥厚的比值增加(比值 1.62,95%置信区间 1.10-2.38)。分析调整了心血管危险因素、尿白蛋白排泄和空腹血糖。因此,高 GFR 与颈动脉粥样硬化和左心室肥厚有关,应在纵向研究中作为显性心血管疾病的可能危险因素进行研究。

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