蛋白尿和估算肾小球滤过率与日本年轻到中年男性高血压发病的相关性。
Associations of proteinuria and the estimated glomerular filtration rate with incident hypertension in young to middle-aged Japanese males.
机构信息
Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of Advanced Medicine in Cardiopulmonary Disease, Nagoya University Graduate School of Medicine, Nagoya, Japan.
出版信息
Prev Med. 2014 Mar;60:48-54. doi: 10.1016/j.ypmed.2013.12.009. Epub 2013 Dec 14.
OBJECTIVE
To investigate the independent associations of proteinuria and the estimated glomerular filtration rate (eGFR) with incident hypertension.
METHODS
We investigated 29,181 Japanese males 18-59years old without hypertension in 2000 and examined whether proteinuria and the eGFR predicted incident hypertension independently over 10years. Incident hypertension was defined as a newly detected blood pressure of ≥140/90mmHg and/or the initiation of antihypertensive drugs. Proteinuria and the eGFR were categorized as dipstick negative (reference), trace or ≥1+ and ≥60 (reference), 50-59.9 or <50ml/min/1.73m(2), respectively. Cox proportional hazards models were used to estimate the hazard ratios (HRs) of incident hypertension.
RESULTS
At baseline, 236 (0.8%) and 477 (1.6%) participants had trace and ≥1+ dipstick proteinuria, while 1416 (4.9%) and 129 (0.4%) participants had an eGFR of 50-59.9 and <50ml/min/1.73m(2), respectively. The adjusted HRs were significant for proteinuria ≥1+ (HRs 1.20, 95% CI: 1.06-1.35) and an eGFR of <50ml/min/1.73m(2) (1.29, 1.03-1.61). When two non-referent categories were combined (dipstick≥trace vs. negative and eGFR<60 vs. ≥60ml/min/1.73m(2)), the association was more significant for proteinuria (1.15, 1.04-1.27) than for eGFR (0.99, 0.92-1.07).
CONCLUSIONS
Proteinuria and a reduced eGFR are independently associated with future hypertension in young to middle-aged Japanese males.
目的
研究蛋白尿和估算肾小球滤过率（eGFR）与高血压发病的独立相关性。
方法
我们调查了 2000 年 18-59 岁无高血压的 29181 名日本男性，研究蛋白尿和 eGFR 是否能独立预测 10 年内高血压的发病情况。新发高血压定义为新发现的血压≥140/90mmHg 和/或开始使用降压药物。蛋白尿和 eGFR 分别分为尿试纸阴性（参照）、微量或≥1+和≥60（参照）、50-59.9 或<50ml/min/1.73m(2)。使用 Cox 比例风险模型估计新发高血压的风险比（HRs）。
结果
基线时，236 名（0.8%）和 477 名（1.6%）参与者有微量和≥1+尿试纸蛋白尿，而 1416 名（4.9%）和 129 名（0.4%）参与者的 eGFR 分别为 50-59.9 和<50ml/min/1.73m(2)。蛋白尿≥1+（HRs 1.20，95%CI：1.06-1.35）和 eGFR<50ml/min/1.73m(2)（1.29，1.03-1.61）的校正 HR 有统计学意义。当将两个非参照类别合并（尿试纸≥微量 vs. 阴性和 eGFR<60 vs. ≥60ml/min/1.73m(2)）时，蛋白尿（1.15，1.04-1.27）的相关性强于 eGFR（0.99，0.92-1.07）。
结论
蛋白尿和估算肾小球滤过率降低与年轻到中年日本男性未来高血压独立相关。
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