Chen Juan, Kong Xianglei, Jia Xiaoyan, Li Wenbin, Wang Zunsong, Cui Meiyu, Xu Dongmei
Department of Nephrology, Shandong Qianfoshan Hospital affiliated to Shandong University, No. 16766, Jingshi Road, Jinan 250014,China.
Department of Nephrology, Shandong Qianfoshan Hospital affiliated to Shandong University, No. 16766, Jingshi Road, Jinan 250014,China.
Clin Chim Acta. 2017 Jul;470:103-108. doi: 10.1016/j.cca.2017.05.012. Epub 2017 May 10.
Few studies have examined the relationships between the prevalence of chronic kidney disease (CKD) and the metabolic risk factors in a developing country such as China, where genetic and environmental backgrounds differ from those in Western countries.
The subjects of this cross-sectional study were the individuals from 18 to 92y. The metabolic syndrome (MetS) was defined based on the criteria of Adult Treatment Panel Third Report (ATP III), but using body mass index (BMI) instead of waist circumference. CKD was defined as decreased estimated glomerular filtration rate (eGFR<60mL/min/1.73m) or presence of proteinuria (urine protein≥1+) assessed using dipstick method.
A total of 26,601 subjects (average age of 48.7y) were analyzed. Among them, the prevalence of the MetS and CKD was 36.4% and 3.0%, respectively. After adjustment for age, gender, cigarette smoking and alcohol drinking, the prevalence of CKD was significantly greater in subjects with than without MetS (OR 1.99, 95% CI 1.57-2.53, p<0.001). Multivariate-adjusted odd ratios for CKD in subjects with 3, 4 or 5 MetS components were 1.82 (95% CI 1.31-2.52, p<0.001), 2.92 (95% CI 2.09-4.09, p<0.001), and 3.07 (95% CI 1.67-5.67, p<0.001), respectively. After further adjustments were made for the other components of MetS, only high fasting glucose (OR 1.52, 95% CI 1.12-2.05) were significant risk factors for reduced renal function(eGFR<60mL/min/1.73m). High blood pressure (OR 1.81, 95% CI 1,42-2.29), high triglycerides (OR 1.34, 95% CI 1.11-1.67) and high fasting glucose (OR 2.07, 95% CI 1.62-2.66) were significant risk factors for proteinuria.
MetS was highly prevalent in the middle-aged and elderly Chinese population in the city of Jinan. There was a graded relationship between the number of MetS components and risk of CKD. High fasting blood glucose levels were the main risk factor of reduced renal function. High blood pressure, high fasting blood glucose levels and high triglycerides were main risk factors for proteinuria.
在诸如中国这样一个遗传和环境背景与西方国家不同的发展中国家，很少有研究探讨慢性肾脏病（CKD）患病率与代谢风险因素之间的关系。
这项横断面研究的对象为18至92岁的个体。代谢综合征（MetS）根据《成人治疗小组第三次报告》（ATP III）的标准定义，但使用体重指数（BMI）而非腰围。CKD定义为估算肾小球滤过率降低（eGFR<60mL/min/1.73m²）或使用试纸法评估存在蛋白尿（尿蛋白≥1+）。
共分析了26,601名受试者（平均年龄48.7岁）。其中，MetS和CKD的患病率分别为36.4%和3.0%。在调整年龄、性别、吸烟和饮酒因素后，患有MetS的受试者中CKD的患病率显著高于未患MetS的受试者（OR 1.99，95%CI 1.57 - 2.53，p<0.001）。患有3、4或5个MetS组分的受试者中CKD的多变量调整比值比分别为1.82（95%CI 1.31 - 2.52，p<0.001）、2.92（95%CI 2.09 - 4.09，p<0.001）和3.07（95%CI 1.67 - 5.67，p<0.001）。在对MetS的其他组分进行进一步调整后，只有高空腹血糖（OR 1.52，95%CI 1.12 - 2.05）是肾功能降低（eGFR<60mL/min/1.73m²）的显著危险因素。高血压（OR 1.81，95%CI 1.42 - 2.29）、高甘油三酯（OR 1.34，95%CI 1.11 - 1.67）和高空腹血糖（OR 2.07，95%CI 1.62 - 2.66）是蛋白尿的显著危险因素。
MetS在济南市的中老年中国人群中高度流行。MetS组分数量与CKD风险之间存在分级关系。高空腹血糖水平是肾功能降低的主要危险因素。高血压、高空腹血糖水平和高甘油三酯是蛋白尿的主要危险因素。
