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肾功能下降是韩国绝经后女性亚临床冠状动脉粥样硬化的一个危险因素。

Decreased Renal Function Is a Risk Factor for Subclinical Coronary Atherosclerosis in Korean Postmenopausal Women.

作者信息

Yun Bo Hyon, Chon Seung Joo, Cho Si Hyun, Choi Young Sik, Lee Byung Seok, Seo Seok Kyo

机构信息

Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.; Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea.

Department of Obstetrics and Gynecology, Gil Hospital, Gachon University College of Medicine, Incheon, Korea.

出版信息

J Menopausal Med. 2016 Dec;22(3):167-173. doi: 10.6118/jmm.2016.22.3.167. Epub 2016 Dec 31.

Abstract

OBJECTIVES

Decreased renal function is associated with increased cardiovascular risk. Our study was planned to verify the association of decreased renal function and subclinical coronary atherosclerosis in postmenopausal women.

METHODS

We performed a retrospective review of 251 Korean postmenopausal women who visited the health promotion center for a routine health checkup. Estimated glomerular filtration rate (eGFR) was used to show renal function, which was estimated by calculated using the Cockcroft-Gault (CG) and the modification of diet in renal disease (MDRD) formulas. Coronary atherosclerosis was assessed by 64-row multidetector computed tomography.

RESULTS

Women with reduced eGFR (< 60 mL/minute/1.73 m) had significantly higher brachial-ankle pulse wave velocity (baPWV) than women with normal eGFR (≥ 60 mL/minute/1.73 m). The eGFR was negatively correlated with baPWV (r = -0.352, < 0.001), significantly. The eGFR was lower in women with coronary atherosclerosis than in normal control women, markedly. Reduced eGFR was significantly associated with the presence of coronary atherosclerosis (odds ratio [OR] = 7.528, 95% confidence interval [CI] = 2.728-20.772, < 0.001).

CONCLUSIONS

Decreased eGFR was closely associated with increased arterial stiffness and coronary atherosclerosis in postmenopausal women. Evaluating subclinical atherosclerosis by screening the renal function in postmenopausal women may be helpful screening high risk group and considering starting menopausal hormone therapy before atherosclerosis development.

摘要

目的

肾功能下降与心血管风险增加相关。我们的研究旨在验证绝经后女性肾功能下降与亚临床冠状动脉粥样硬化之间的关联。

方法

我们对251名到健康促进中心进行常规健康检查的韩国绝经后女性进行了回顾性研究。采用估算的肾小球滤过率(eGFR)来反映肾功能,其通过Cockcroft-Gault(CG)公式和肾脏病饮食改良(MDRD)公式计算得出。通过64排多层螺旋计算机断层扫描评估冠状动脉粥样硬化情况。

结果

eGFR降低(<60 ml/分钟/1.73 m²)的女性肱踝脉搏波速度(baPWV)显著高于eGFR正常(≥60 ml/分钟/1.73 m²)的女性。eGFR与baPWV呈显著负相关(r = -0.352,P < 0.001)。冠状动脉粥样硬化女性的eGFR明显低于正常对照女性。eGFR降低与冠状动脉粥样硬化的存在显著相关(优势比[OR] = 7.528,95%置信区间[CI] = 2.728 - 20.772,P < 0.001)。

结论

绝经后女性eGFR降低与动脉僵硬度增加和冠状动脉粥样硬化密切相关。通过筛查绝经后女性的肾功能来评估亚临床动脉粥样硬化可能有助于筛查高危人群,并考虑在动脉粥样硬化发展之前开始绝经激素治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/472f/5256359/049ae388fdc3/jmm-22-167-g001.jpg

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