a Department of Health Development, Institute of Industrial Ecological Sciences , University of Occupational and Environmental Health , Kitakyushu , Japan.
b Fukuoka University Institute for Physical Activity , Fukuoka , Japan.
Clin Exp Hypertens. 2017;39(7):645-654. doi: 10.1080/10641963.2017.1306541. Epub 2017 Jun 7.
Chronic kidney disease (CKD) may be an etiologic cause of aging, hypertension, diabetes mellitus (DM), and metabolic syndrome. However, the influence of these cardiovascular risk factors and their combination on the development of CKD remains controversial. This retrospective study evaluated the influence of cardiovascular risk factors and their combination on the incidence of CKD during a 6-year follow-up period in middle-aged and older males.
The subjects were 303 males without a history of cardiovascular disease, stroke, renal dysfunction, or dialysis treatment. A biochemical analysis, blood pressure (BP) analysis, and anthropometry measurements were performed every year, and the classification of CKD was also assessed based on the estimated glomerular filtration rate (<60 ml/min/1.73 m) and/or presence of proteinuria.
After 6 years, the incidence of CKD was noted in 32 subjects. According to a multivariable analysis, hypertension (hazard ratio [HR]: 3.95, 95% confidence of interval [CI]: 1.64-9.49, p = 0.002) and hyperglycemia (HR: 3.27, 95% CI: 1.42-7.56, p = 0.006) were significantly associated with the incidence of CKD. According to a Cox proportional hazards model, the HR for the incidence of CKD was significantly higher in the combination of high-normal BP/hypertension and impaired fasting glucose/DM group than in the combination of normotensive and normal glucose tolerance group (HR: 7.16, 95% CI: 2.43-17.25, p = 0.001).
These results suggest that the hypertension and hyperglycemia and their combination may be associated with the incidence of CKD.
慢性肾脏病(CKD)可能是衰老、高血压、糖尿病(DM)和代谢综合征的病因。然而,这些心血管危险因素及其组合对 CKD 发展的影响仍存在争议。本回顾性研究评估了心血管危险因素及其组合对中年及以上男性 6 年随访期间 CKD 发生率的影响。
本研究的受试者为 303 名无心血管疾病、中风、肾功能不全或透析治疗史的男性。每年进行一次生化分析、血压(BP)分析和人体测量学测量,并根据估计肾小球滤过率(<60ml/min/1.73m)和/或蛋白尿的存在评估 CKD 的分类。
6 年后,32 名受试者发生 CKD。多变量分析显示,高血压(危险比[HR]:3.95,95%置信区间[CI]:1.64-9.49,p=0.002)和高血糖(HR:3.27,95%CI:1.42-7.56,p=0.006)与 CKD 的发生显著相关。根据 Cox 比例风险模型,高正常血压/高血压与空腹血糖受损/糖尿病组的 CKD 发生率 HR 明显高于正常血压/正常血糖耐量组(HR:7.16,95%CI:2.43-17.25,p=0.001)。
这些结果表明,高血压和高血糖及其组合可能与 CKD 的发生有关。