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腹型肥胖和腰高比与慢性肾脏病:横断面和前瞻性研究。

The hypertriglyceridemic waist and waist-to-height ratio phenotypes and chronic kidney disease: Cross-sectional and prospective investigations.

机构信息

Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Obes Res Clin Pract. 2017 Sep-Oct;11(5):585-596. doi: 10.1016/j.orcp.2016.11.003. Epub 2016 Nov 23.

Abstract

AIMS

We investigated the association between two hypertriglyceridemic waist (HW) and waist-to height ratio (HWHtR) phenotypes and chronic kidney disease (CKD) using cross sectional and prospective analysis.

METHODS

Data of 12,012 individuals (44% men) of the Tehran Lipid and Glucose Study (TLGS) at two phases [(1999-2001) and (2002-2005)], were used for cross-sectional analysis. This population was followed until 2014 with median follow-up 12.4 years (95% confidence interval (CI): 11.8; 12.4). The data of 8225 individuals (45% men) were used for prospective analysis. The outcome was the development of CKD defined as estimated glomerular filtration rate (eGFR) <60mL/min/1.73m. The HW phenotype was defined as waist circumference (WC) >90cm in men and >85cm in women, along with TGs >2.0mmol/L. The HWHtR phenotype was defined as waist-to-height ratio (WHtR) >0.5 and TGs >2mmol/L. Multivariable logistic and Cox regression were used to statistical analysis.

RESULTS

Cross sectional analysis showed that in women, both HW and HWHtR phenotypes were associated with CKD after controlling for confounders [(OR: 1.37, CI: 1.01-1.86, p<0.05) and (OR: 1.58, CI: 1.03-2.41, p<0.05)], respectively. Among men, HW and HWHtR were associated with prevalent CKD in unadjusted and age adjusted models; these associations were not significant after further adjustment for confounders. In prospective analysis, neither HW nor HWHtR phenotypes were significant predictor for CKD progression.

CONCLUSION

HW and HWHtR phenotypes were associated with prevalent CKD in cross sectional setting. In prospective analysis HW and HWHtR did not show significant effect in prediction of CKD.

摘要

目的

本研究通过横断面和前瞻性分析,探讨两种高三酰甘油性腰围(HW)和腰围身高比(HWHtR)表型与慢性肾脏病(CKD)之间的关联。

方法

使用 Tehran Lipid and Glucose Study(TLGS)的数据进行横断面分析,该研究共纳入了 12012 名个体(44%为男性),分两个阶段(1999-2001 年和 2002-2005 年)进行研究。该人群随访至 2014 年,中位随访时间为 12.4 年(95%置信区间(CI):11.8;12.4)。前瞻性分析使用了 8225 名个体(45%为男性)的数据。结局为 CKD 的发生,定义为估计肾小球滤过率(eGFR)<60mL/min/1.73m。HW 表型定义为男性腰围(WC)>90cm,女性腰围>85cm,同时三酰甘油(TGs)>2.0mmol/L。HWHtR 表型定义为腰围身高比(WHtR)>0.5,TGs>2mmol/L。采用多变量逻辑回归和 Cox 回归进行统计学分析。

结果

横断面分析显示,在校正混杂因素后,女性中 HW 和 HWHtR 表型均与 CKD 相关[比值比(OR):1.37,95%置信区间(CI):1.01-1.86,p<0.05]和[OR:1.58,95%置信区间(CI):1.03-2.41,p<0.05)]。在男性中,HW 和 HWHtR 与未校正和年龄校正模型中的 CKD 患病率相关;在校正混杂因素后,这些关联无统计学意义。在前瞻性分析中,HW 和 HWHtR 表型均不是 CKD 进展的显著预测因子。

结论

HW 和 HWHtR 表型与横断面研究中的 CKD 患病率相关。在前瞻性分析中,HW 和 HWHtR 对 CKD 无显著预测作用。

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