Katoh Takeaki, Kawamoto Ryuichi, Kohara Katsuhiko, Miki Tetsuro
Department of Community Medicine, Ehime University Graduate School of Medicine, Ehime 791-0295, Japan; Department of Geriatric Medicine, Ehime University Graduate School of Medicine, Ehime 791-0295, Japan.
Department of Community Medicine, Ehime University Graduate School of Medicine, Ehime 791-0295, Japan.
Int Sch Res Notices. 2015 Jan 26;2015:480418. doi: 10.1155/2015/480418. eCollection 2015.
The subjects comprised 230 men aged 77 ± 10 (range: 50-100) years and 279 women aged 81 ± 10 (50-101) years that visited the medical department. We examined the relationship between increased serum bilirubin and renal function evaluated by estimated glomerular filtration rate (eGFR) using CKD-EPI equations modified by a Japanese coefficient. Compared with the fourth quartile in serum bilirubin (1.01-1.97 mg/dL), the nonadjusted, age and gender-adjusted, and multivariate-adjusted odds ratios {95% confidence interval (CI)} of eGFR <60 mL/min/1.73 m(2) for the first quartile in serum bilirubin (0.13-0.50 mg/dL) were 2.08 (1.25-3.44), 1.82 (1.07-3.09), and 1.53 (0.83-2.81), respectively. Moreover, compared with the fourth quartile, nonadjusted, age and gender-adjusted, and multivariate-adjusted odds ratios (95% CI) of eGFR <45 mL/min/1.73 m(2) for the first quartile were 3.50 (1.95-6.23), 3.12 (1.72-5.65), and 3.53 (1.71-7.26), respectively. The data were further stratified by gender, age, medication (antihypertensive, antidyslipidemic, and antidiabetic agents), and prevalence of cardiovascular disease (CVD). The standardized coefficients for eGFR were significant in all the subgroups other than the prevalence of CVD, and there were significant interactions between the two groups regarding CVD. Our data demonstrated an independent positive association between serum bilirubin and eGFR among diabetic patients.
研究对象包括230名年龄在77±10(范围:50 - 100)岁的男性和279名年龄在81±10(50 - 101)岁的女性,他们均前往内科就诊。我们使用经日本系数修正的CKD - EPI方程,研究血清胆红素升高与通过估计肾小球滤过率(eGFR)评估的肾功能之间的关系。与血清胆红素第四四分位数(1.01 - 1.97mg/dL)相比,血清胆红素第一四分位数(0.13 - 0.50mg/dL)时eGFR<60mL/min/1.73m²的未调整、年龄和性别调整以及多变量调整比值比{95%置信区间(CI)}分别为2.08(1.25 - 3.44)、1.82(1.07 - 3.09)和1.53(0.83 - 2.81)。此外,与第四四分位数相比,第一四分位数时eGFR<45mL/min/1.73m²的未调整、年龄和性别调整以及多变量调整比值比(95%CI)分别为3.50(1.95 - 6.23)、3.12(1.72 - 5.65)和3.53(1.71 - 7.26)。数据进一步按性别、年龄、用药情况(抗高血压药、抗血脂药和抗糖尿病药)以及心血管疾病(CVD)患病率进行分层。除CVD患病率外,所有亚组中eGFR的标准化系数均显著,且两组在CVD方面存在显著交互作用。我们的数据表明糖尿病患者血清胆红素与eGFR之间存在独立的正相关关系。