Shimizu Motohiro, Furusyo Norihiro, Mitsumoto Fujiko, Takayama Koji, Ura Kazuya, Hiramine Satoshi, Ikezaki Hiroaki, Ihara Takeshi, Mukae Haru, Ogawa Eiichi, Toyoda Kazuhiro, Kainuma Mosaburo, Murata Masayuki, Hayashi Jun
Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan.
Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan.
Atherosclerosis. 2015 Feb;238(2):207-12. doi: 10.1016/j.atherosclerosis.2014.12.013. Epub 2014 Dec 9.
To examine whether or not subclinical atherosclerosis independently predicts the incidence of chronic kidney disease (CKD) in the Japanese general population.
This study is part of the Kyushu and Okinawa Population Study (KOPS), a survey of vascular events associated with lifestyle-related diseases. Participants who attended both baseline (2004-2007) and follow-up (2009-2012) examinations were eligible. The common carotid intima-media thickness (IMT) was assessed for each participant at baseline. The end point was the incidence of CKD, defined as an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m(2) during the follow-up of participants without CKD at baseline.
During the five-year follow-up, 224 of the 1824 participants (12.3%) who developed CKD had higher carotid IMT (0.74 ± 0.22 vs. 0.65 ± 0.14 mm, P < 0.001), higher triglycerides (1.6 ± 0.8 vs. 1.3 ± 0.7 mmol/L, P < 0.001), and lower high density lipoprotein cholesterol (1.5 ± 0.4 vs. 1.6 ± 0.4 mmol/L, P < 0.001) at baseline than those who did not. In logistic regression analysis adjusted for significant covariates, eGFR (Odds ratio [OR] 0.83, 95% confidence interval (CI) 0.80-0.85, P < 0.001), carotid IMT (0.10 mm increase: OR 1.17, 95% CI 1.04-1.33, P = 0.010), and triglycerides (OR 1.35, 95% CI 1.06-1.73, P = 0.015) at baseline were independent predictors for the development of CKD.
Higher carotid IMT and hypertriglyceridemia were independently associated with the development of CKD in the population studied.
研究亚临床动脉粥样硬化是否能独立预测日本普通人群慢性肾脏病（CKD）的发病率。
本研究是九州和冲绳人群研究（KOPS）的一部分，该研究旨在调查与生活方式相关疾病有关的血管事件。参加了基线检查（2004 - 2007年）和随访检查（2009 - 2012年）的参与者符合条件。在基线时对每位参与者的颈总动脉内膜中层厚度（IMT）进行评估。终点是CKD的发病率，定义为基线时无CKD的参与者在随访期间估计肾小球滤过率（eGFR）<60 mL/min/1.73 m²。
在五年随访期间，1824名发生CKD的参与者中有224名（12.3%）在基线时的颈动脉IMT更高（0.74±0.22 vs. 0.65±0.14 mm，P<0.001），甘油三酯更高（1.6±0.8 vs. 1.3±0.7 mmol/L，P<0.001），高密度脂蛋白胆固醇更低（1.5±0.4 vs. 1.6±0.4 mmol/L，P<0.001），与未发生CKD的参与者相比。在对显著协变量进行校正的逻辑回归分析中，基线时的eGFR（比值比[OR]0.83，95%置信区间[CI]0.80 - 0.85，P<0.001）、颈动脉IMT（增加0.10 mm：OR 1.17，95%CI 1.04 - 1.33，P = 0.010）和甘油三酯（OR 1.35，95%CI 1.06 - 1.73，P = 0.015）是CKD发生的独立预测因素。
在本研究人群中，较高的颈动脉IMT和高甘油三酯血症与CKD的发生独立相关。
