Department of Occupational and Environmental Health and Ministry of Education Key Lab for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
Sci Rep. 2017 Aug 30;7(1):9987. doi: 10.1038/s41598-017-09591-6.
Estimated glomerular filtration rate (eGFR) has been reported to be associated with risk of incident coronary heart disease (CHD), and blood urea nitrogen (BUN) has been shown to be a strong predictor of mortality in patients with heart failure (HF). However, such epidemiological evidence from Chinese population was still limited. We used Cox proportional-hazards regression models to investigate the associations of eGFR and BUN with risk of incident CHD in the prospective Dongfeng-Tongji (DFTJ) cohort. After fully adjusted for potential confounders, a 10-unit decline in eGFR was associated with higher risk for CHD (hazard ratio [HR] 1.05, 95% confidence interval [CI] 1.01-1.09); compared with individuals with normal eGFR levels (eGFR ≥ 90 ml/min per 1.73 m), individuals with a mild-to-severe eGFR decline (15 to 60 ml/min per 1.73 m) were at significantly greater risk for CHD (HR 1.25, 95% CI 1.05-1.48; P = 0.011). Compared with individuals in the lowest tertile of BUN, those in the highest tertile were at significantly greater risk for CHD (HR 1.17, 95% CI 1.03-1.33; P = 0.014). In conclusion, a mild-to-severe decline in eGFR or a raised level of BUN might be associated with increased risk of incident CHD in middle-aged and elderly Chinese populations.
估算肾小球滤过率（eGFR）与冠心病（CHD）发病风险相关，血尿素氮（BUN）是心力衰竭（HF）患者死亡率的强预测指标。然而，中国人群的此类流行病学证据仍然有限。我们使用 Cox 比例风险回归模型，在前瞻性东风-同济（DFTJ）队列中研究 eGFR 和 BUN 与 CHD 发病风险的相关性。在充分调整潜在混杂因素后，eGFR 每下降 10 个单位，CHD 发病风险增加（风险比 [HR] 1.05，95%置信区间 [CI] 1.01-1.09）；与 eGFR 水平正常（eGFR≥90ml/min/1.73m）的个体相比，eGFR 轻度至重度下降（15 至 60ml/min/1.73m）的个体发生 CHD 的风险显著增加（HR 1.25，95%CI 1.05-1.48；P=0.011）。与 BUN 最低三分位数的个体相比，BUN 最高三分位数的个体发生 CHD 的风险显著增加（HR 1.17，95%CI 1.03-1.33；P=0.014）。总之，eGFR 轻度至重度下降或 BUN 水平升高可能与中国中老年人群 CHD 发病风险增加相关。
