Lin Lin, Peng Kui, Du Rui, Huang Xiaolin, Sun Wanwan, Ding Lin, Wang Po, Huang Ya, Xu Yu, Xu Min, Chen Yuhong, Bi Yufang, Wang Weiqing, Lu Jieli
aState Key Laboratory of Medical Genomics, National Clinical Research Center for Metabolic Diseases, Collaborative Innovation Center of Systems BiomedicinebShanghai Institute of Endocrine and Metabolic Diseases, Department of Endocrine and Metabolic Diseases, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
J Hypertens. 2017 Feb;35(2):385-391. doi: 10.1097/HJH.0000000000001158.
Decreased glomerular filtration rate (GFR) has been suspected as a risk factor for arterial stiffness. Whether high GFR is the risk factor of arterial stiffness and cardiovascular disease remains uncertain. We aim to evaluate the association between high estimated GFR (eGFR) and arterial stiffness in Chinese adults.
We performed a cross-sectional study involving 9136 Chinese adults without chronic kidney disease. Arterial stiffness was measured by brachial-ankle pulse wave velocity (baPWV) and pulse pressure (PP). We divided participants into four groups according to age-specific quartiles of eGFR. Renal hyperfiltration (RHF) was defined with the highest age-specific quartile of eGFR. The odds ratios (ORs) of elevated baPWV and PP were estimated using multivariate logistic regression models and were further tested using propensity score matching analysis between participants with or without RHF.
RHF was associated with 11 and 32% higher risk of elevated baPWV and PP in age-adjusted models, P = 0.35 and 0.005, respectively. After adjusting for covariates, RHF was significantly associated with 23 and 39% increased risk of elevated baPWV and PP, P = 0.01 and 0.001, respectively. These associations were further confirmed in propensity score matching analysis. The adjusted ORs (95% confidence interval) were 1.17 (1.03-1.30) for elevated baPWV and 1.28 (1.13-1.46) for elevated PP, P = 0.02 and P value less than 0.001, respectively.
RHF was associated with elevated baPWV and PP, suggesting that RHF might be an early indicator for the detection of arterial stiffness.
肾小球滤过率（GFR）降低一直被怀疑是动脉僵硬度的一个危险因素。高GFR是否为动脉僵硬度和心血管疾病的危险因素仍不确定。我们旨在评估中国成年人中高估算肾小球滤过率（eGFR）与动脉僵硬度之间的关联。
我们进行了一项横断面研究，纳入了9136名无慢性肾脏病的中国成年人。通过臂踝脉搏波速度（baPWV）和脉压（PP）来测量动脉僵硬度。我们根据eGFR的年龄特异性四分位数将参与者分为四组。肾高滤过（RHF）定义为eGFR处于最高年龄特异性四分位数。使用多变量逻辑回归模型估计baPWV和PP升高的比值比（OR），并通过倾向评分匹配分析对有或无RHF的参与者进行进一步检验。
在年龄调整模型中，RHF与baPWV升高和PP升高的风险分别高出11%和32%相关，P值分别为0.35和0.005。在调整协变量后，RHF与baPWV升高和PP升高的风险分别显著增加23%和39%相关，P值分别为0.01和0.001。这些关联在倾向评分匹配分析中得到进一步证实。baPWV升高的调整后OR（95%置信区间）为1.17（1.03 - 1.30），PP升高的调整后OR为1.28（1.13 - 1.46），P值分别为0.02和小于0.001。
RHF与baPWV升高和PP升高相关，提示RHF可能是检测动脉僵硬度的一个早期指标。
