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中国农村人口中的泌尿系统结石病与心血管疾病风险

Urinary Stone Disease and Cardiovascular Disease Risk in a Rural Chinese Population.

作者信息

Fan Xiaohong, Kalim Sahir, Ye Wenling, Zhao Sophia, Ma Jie, Nigwekar Sagar U, Chan Kevin E, Cui Jie, Cai Jianfang, Wang Liang, Heng Wei, Zhou Yali, Sun Ying, Cui Rui, Zhang Wei, Wang Baobao, Dai Qing, Li Xuewang, Thadhani Ravi, Li Xuemei

机构信息

Department of Nephrology, Peking Union Medical College Hospital, Beijing, China.

Department of Nephrology, Massachusetts General Hospital, Boston, Massachusetts, USA.

出版信息

Kidney Int Rep. 2017 Jun 8;2(6):1042-1049. doi: 10.1016/j.ekir.2017.06.001. eCollection 2017 Nov.

Abstract

INTRODUCTION

Urinary stone disease (USD) is associated with cardiovascular disease (CVD) in Western populations. However, the prevalence and relationship between USD and CVD risk have not been fully examined in the Chinese population.

METHODS

We performed a cross-sectional study of 10,281 participants in rural China. All subjects underwent renal ultrasound to detect USD, brachial-ankle pulsewave velocity (baPWV) measurement to estimate arterial stiffness, and ankle-brachial index (ABI) examination to detect peripheral arterial disease (PAD) (defined as ABI <0.9 on at least 1 side of the body).

RESULTS

Mean age of the study population was 55.4 ± 10.0 years; 47.1% were men. Among all participants, 5.7% (n = 582) had USD, mean baPWV was 15.6 ± 3.2 m/s, and 4.0% had PAD. The prevalence of USD increased in parallel with mean arterial pressure, albuminuria, Framingham risk score, and baPWV. In multivariate analyses after adjustment for demographic characteristics, USD was significantly associated with an increased risk of hypertension (odds ratio [OR]: 1.32; 95% confidence interval [CI]: 1.08-1.62), albuminuria (OR: 2.17; 95% CI: 1.74-2.69), chronic kidney disease (OR: 2.11; 95% CI: 1.70-2.62), increased arterial stiffness (OR: 1.24; 95% CI: 1.01-1.52), and PAD (OR: 1.50; 95% CI: 1.04-2.16).

DISCUSSION

In rural China, USD was associated with a high prevalence of traditional CVD risk factors, increased arterial stiffness, and PAD. The presence of USD should increase physician awareness of the concomitant presence of CVD risk factors.

摘要

引言

在西方人群中,泌尿系统结石病(USD)与心血管疾病(CVD)相关。然而,在中国人群中,USD与CVD风险之间的患病率及关系尚未得到充分研究。

方法

我们对中国农村地区的10281名参与者进行了一项横断面研究。所有受试者均接受肾脏超声检查以检测USD,测量臂踝脉搏波速度(baPWV)以评估动脉僵硬度,并进行踝臂指数(ABI)检查以检测外周动脉疾病(PAD)(定义为身体至少一侧的ABI<0.9)。

结果

研究人群的平均年龄为55.4±10.0岁;47.1%为男性。在所有参与者中,5.7%(n=582)患有USD,平均baPWV为15.6±3.2米/秒,4.0%患有PAD。USD的患病率与平均动脉压、蛋白尿、弗雷明汉风险评分和baPWV平行增加。在对人口统计学特征进行调整后的多变量分析中,USD与高血压风险增加显著相关(优势比[OR]:1.32;95%置信区间[CI]:1.08-1.62)、蛋白尿(OR:2.17;95%CI:1.74-2.69)、慢性肾脏病(OR:2.11;95%CI:1.70-2.62)、动脉僵硬度增加(OR:1.24;95%CI:1.01-1.52)和PAD(OR:1.50;95%CI:1.04-2.16)。

讨论

在中国农村地区,USD与传统CVD风险因素的高患病率、动脉僵硬度增加和PAD相关。USD的存在应提高医生对CVD风险因素并存的认识。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e0dc/5733875/77e52cfde462/gr1.jpg

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