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代谢综合征与估算肾小球滤过率轻度降低独立相关:一项横断面研究。

Metabolic syndrome is independently associated with a mildly reduced estimated glomerular filtration rate: a cross-sectional study.

作者信息

Hu Wen, Wu Xiao-Juan, Ni Yao-Jun, Hao Hai-Rong, Yu Wei-Nan, Zhou Hong-Wen

机构信息

Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210029, China.

Department of Endocrinology and Metabolism, Huai'an Hospital Affiliated to Xuzhou Medical University and Huai'an Second People's Hospital, Huai'an, 223001, China.

出版信息

BMC Nephrol. 2017 Jun 13;18(1):192. doi: 10.1186/s12882-017-0597-3.

Abstract

BACKGROUND

Association between metabolic syndrome (MS) and mildly reduced estimated glomerular filtration rates (eGFRs) remains unclear. Therefore, we aimed to evaluate the association between MS and a mildly reduced eGFR in Chinese adults.

METHODS

Anthropometric and biochemical examinations were performed in 2992 individuals. The eGFR was calculated from the creatinine level. MS was defined according to the Adult Treatment Panel III criteria as the presence of three or more risk factors. Mildly reduced eGFR was defined as a value between 60 and 90 mL/min/1.73 m. Multiple linear regression and multiple logistic regression analysis were used to evaluate association between metabolic syndrome and estimate glomerular filtration rate.

RESULTS

After adjusting for several potential confounders, the participants with MS showed a 1.29-fold increased odds ratio for a mildly reduced eGFR compared with those without MS. Additionally, the odds ratios (and 95% confidence intervals (CIs)) for mildly reduced eGFR in participants with elevated triglycerides (TG), decreased high-density lipoprotein (HDL), obesity and elevated fasting blood glucose (FPG) after multivariable adjustment were 1.25 (1.05-1.49), 1.23 (1.03-1.48), 1.22 (1.03-1.45) and 0.64 (0.52-0.78), respectively. The odds ratios (95% CIs) for hyperfiltration in participants with elevated FPG and HbA1c levels after multivariable adjustment were 1.53 (1.30-1.81) and 2.86 (2.00-4.09), respectively.

CONCLUSIONS

MS is associated with an increased risk of a mildly reduced eGFR in the Chinese population, and several individual components of MS have different impacts on eGFR levels. MS had dual roles on renal damage.

TRIAL REGISTRATION

ChiCTR-TRC- 14005029 . Registered 28 July 2014.

摘要

背景

代谢综合征(MS)与估算肾小球滤过率(eGFR)轻度降低之间的关联尚不清楚。因此,我们旨在评估中国成年人中MS与eGFR轻度降低之间的关联。

方法

对2992名个体进行了人体测量和生化检查。根据肌酐水平计算eGFR。MS根据成人治疗小组III标准定义为存在三个或更多危险因素。eGFR轻度降低定义为60至90 mL/min/1.73m之间的值。采用多元线性回归和多元逻辑回归分析评估代谢综合征与估算肾小球滤过率之间的关联。

结果

在调整了几个潜在的混杂因素后,与没有MS的参与者相比,患有MS的参与者eGFR轻度降低的比值比增加了1.29倍。此外,在多变量调整后,甘油三酯(TG)升高、高密度脂蛋白(HDL)降低、肥胖和空腹血糖(FPG)升高的参与者中,eGFR轻度降低的比值比(及95%置信区间(CI))分别为1.25(1.05-1.49)、1.23(1.03-1.48)、1.22(1.03-1.45)和0.64(0.52-0.78)。在多变量调整后,FPG和糖化血红蛋白(HbA1c)水平升高的参与者中,超滤的比值比(95%CI)分别为1.53(1.30-1.81)和2.86(2.00-4.09)。

结论

在中国人群中,MS与eGFR轻度降低风险增加相关,MS的几个个体组成部分对eGFR水平有不同影响。MS对肾损伤具有双重作用。

试验注册

ChiCTR-TRC-14005029。2014年7月28日注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/22c5/5470228/b262965aa340/12882_2017_597_Fig1_HTML.jpg

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