Lu Jieli, Mu Yiming, Su Qing, Shi Lixin, Liu Chao, Zhao Jiajun, Chen Lulu, Li Qiang, Yang Tao, Yan Li, Wan Qin, Wu Shengli, Liu Yan, Wang Guixia, Luo Zuojie, Tang Xulei, Chen Gang, Huo Yanan, Gao Zhengnan, Ye Zhen, Wang Youmin, Qin Guijun, Deng Huacong, Yu Xuefeng, Shen Feixia, Chen Li, Zhao Liebin, Sun Jichao, Sun Wanwan, Wang Tiange, Du Rui, Lin Lin, Dai Meng, Xu Yu, Xu Min, Bi Yufang, Lai Shenghan, Li Donghui, Wang Weiqing, Ning Guang
State Key Laboratory of Medical Genomics, Key Laboratory for Endocrine and Metabolic Diseases of Ministry of Health, National Clinical Research Center for Metabolic Diseases, Collaborative Innovation Center of Systems Biomedicine, Shanghai Jiao-Tong University School of Medicine, Shanghai, China Shanghai Clinical Center for Endocrine and Metabolic Diseases, Rui-Jin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China.
Chinese People's Liberation Army General Hospital, Beijing, China.
J Am Heart Assoc. 2016 Jul 22;5(7):e003328. doi: 10.1161/JAHA.116.003328.
Chronic kidney disease (CKD) increases cardiovascular disease (CVD) risk. However, the association of mildly reduced kidney function with CVD risk is unclear.
This study investigated the association of estimated glomerular filtration rate (eGFR) with prevalent CVDs, 10-year Framingham risk for coronary heart disease (CHD), and 10-year risk of atherosclerotic cardiovascular diseases (ASCVD) in 239 832 participants from the baseline of the Risk Evaluation of cAncers in Chinese diabeTic Individuals: a lONgitudinal study. With an interviewer-assisted questionnaire, we collected information on CVD, including reported CHD, stroke, or myocardial infarction. Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) equation was used to calculate eGFR. Compared with individuals with normal eGFR (≥90 mL/min per 1.73 m(2)), those with decreased eGFR (75-89, 60-74, and <60 mL/min per 1.73 m(2)) had higher risk of prevalent obesity, diabetes mellitus, hypertension, and dyslipidemia in both men and women (P for trend all <0.001). Moreover, a significantly higher 10-year Framingham risk for CHD and 10-year risk for ASCVD was observed in both men and women with mildly decreased eGFR (60-89 mL/min per 1.73 m(2)).
Even mildly reduced eGFR (under 90 mL/min per 1.73 m(2)) is associated with elevated 10-year Framingham risk for CHD and 10-year ASCVD risk among Chinese adults.
慢性肾脏病（CKD）会增加心血管疾病（CVD）风险。然而，肾功能轻度降低与CVD风险之间的关联尚不清楚。
本研究在中国糖尿病个体癌症风险评估纵向研究的239832名参与者中，调查了估计肾小球滤过率（eGFR）与CVD患病率、冠心病（CHD）10年弗明汉风险以及动脉粥样硬化性心血管疾病（ASCVD）10年风险之间的关联。通过访员协助的问卷，我们收集了CVD相关信息，包括报告的CHD、中风或心肌梗死。采用慢性肾脏病流行病学协作组（CKD-EPI）公式计算eGFR。与eGFR正常（≥90 mL/min per 1.73 m²）的个体相比，eGFR降低（75 - 89、60 - 74以及<60 mL/min per 1.73 m²）的个体，无论男性还是女性，患肥胖症、糖尿病、高血压和血脂异常的风险均更高（趋势P值均<0.001）。此外，eGFR轻度降低（60 - 89 mL/min per 1.73 m²）的男性和女性，CHD的10年弗明汉风险以及ASCVD的10年风险均显著更高。
在中国成年人中，即使是轻度降低的eGFR（低于90 mL/min per 1.73 m²）也与CHD的10年弗明汉风险升高以及ASCVD的10年风险升高相关。
