Jin Bo, Bai Xiaojuan, Han Lulu, Liu Jing, Zhang Weiguang, Chen Xiangmei
Department of Gerontology and Geriatrics, Shengjing Hospital of China Medical University, Shenyang, China.
Department of Circulation, Asia Heart Hospital, Wuhan, China.
PLoS One. 2014 Jan 20;9(1):e86082. doi: 10.1371/journal.pone.0086082. eCollection 2014.
Chronic kidney disease (CKD) is generally considered an independent risk factor for cardiovascular disease (CVD) development, but rates in individuals with estimated glomerular filtration rate (eGFR) >60 ml/min/1.73 m(2) are uncertain. The Framingham global CVD risk score (FRS) equation is a widely accepted tool used to predict CVD risk in the general population. The purpose of the present study was to examine whether an association exists between eGFR and FRS in a Chinese population with no CKD or CVD.
A total of 333 participants were divided into three groups based on FRS. The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation and CKD-EPI equation for Asians (CKD-EPI-ASIA) were used to measure eGFR.
A significant inverse association between eGFR and FRS was confirmed with Pearson correlation coefficients of -0.669, -0.698 (eGFR(CKD-EPI), P<0.01) and -0.658, -0.690 (eGFR(CKD-EPI)-ASIA, P<0.01). This association gradually diminished with progression from the low- to high-risk groups (eGFR(CKD-EPI), r = -0.615, -0.282, -0.197, P<0.01, P<0.01, P>0.05; similar results according to the CKD-EPI-ASIA equation). In the low- or moderate-risk new-groups, this association became stronger with increased FRS (eGFR(CKD-EPI)-ASIA, r = -0557, -0.622 or -0.326, -0.329, P<0.01). In contrast to the results from 2008, eGFR was independently associated with FRS following adjustment for traditional cardiovascular risk factors (P<0.05).
Renal function has multiple influences on predicting CVD risk in various populations. With increasing FRS and decreasing eGFR, it is also independently associated with CVD, even in individuals with eGFR >60 ml/min/1.73 m(2).
慢性肾脏病（CKD）通常被认为是心血管疾病（CVD）发生的独立危险因素，但估计肾小球滤过率（eGFR）>60 ml/min/1.73 m² 的个体中CVD发生率尚不确定。弗雷明汉全球CVD风险评分（FRS）方程是一种广泛用于预测普通人群CVD风险的工具。本研究旨在探讨在无CKD或CVD的中国人群中，eGFR与FRS之间是否存在关联。
根据FRS将333名参与者分为三组。采用慢性肾脏病流行病学协作组（CKD-EPI）方程和亚洲人CKD-EPI方程（CKD-EPI-ASIA）测量eGFR。
eGFR与FRS之间存在显著负相关，Pearson相关系数分别为-0.669、-0.698（eGFR(CKD-EPI)，P<0.01）和-0.658、-0.690（eGFR(CKD-EPI)-ASIA，P<0.01）。随着从低风险组到高风险组的进展，这种关联逐渐减弱（eGFR(CKD-EPI)，r = -0.615、-0.282、-0.197，P<0.01、P<0.01、P>0.05；根据CKD-EPI-ASIA方程结果相似）。在低风险或中风险新分组中，随着FRS增加，这种关联变得更强（eGFR(CKD-EPI)-ASIA，r = -0.557、-0.622或-0.326、-0.329，P<0.01）。与2008年的结果相反，在调整传统心血管危险因素后，eGFR与FRS独立相关（P<0.05）。
肾功能对预测不同人群的CVD风险有多种影响。随着FRS增加和eGFR降低，即使在eGFR>60 ml/min/1.73 m² 的个体中，它也与CVD独立相关。
