Okada Rieko, Yasuda Yoshinari, Tsushita Kazuyo, Wakai Kenji, Hamajima Nobuyuki, Matsuo Seiichi
Department of Preventive Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
Department of Nephrology, Internal Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Clin Exp Nephrol. 2018 Dec;22(6):1387-1394. doi: 10.1007/s10157-018-1601-3. Epub 2018 Jun 22.
The purpose of this study is to determine the association of dipstick-determined trace proteinuria with metabolic syndrome (MetS) and its components in each age, gender, and eGFR category among a large general population.
A total of 270,190 people (102,223 men and 167,967 women) aged 40-74 years were included. Subjects were categorized as having negative, trace, and positive proteinuria by the dipstick method.
The prevalence of MetS increased with increasing levels of proteinuria in any estimated glomerular filtration rate (eGFR) category (odds ratios for MetS relative to negative proteinuria: 1.22, 1.23, and 1.25 for trace proteinuria, and 2.19, 1.81, and 1.80 for positive proteinuria among subjects with eGFR of ≥ 90, 60-89, and 45-59 ml/min/1.73 m, respectively). These associations were statistically significant in each age and sex category. Among MetS components, the prevalence of hypertension and diabetes increased with increasing levels of proteinuria (odds ratios for hypertension: 1.23 and 1.87, and odds ratios for diabetes: 1.28 and 2.18 for trace and positive proteinuria, respectively), which were similarly observed in any eGFR category. There were little or no differences in the prevalence of abdominal obesity and dyslipidemia (reduced HDL-cholesterol and/or elevated triglycerides) between the levels of proteinuria.
Subjects with dipstick-determined trace proteinuria showed intermediate risk of having MetS, hypertension, and diabetes between negative and positive proteinuria in any eGFR category in a large general population. Thus, MetS components should be checked for subjects with trace proteinuria even in those with normal eGFR for the early prevention of cardiovascular diseases.
本研究旨在确定在一大群普通人群中，通过试纸法测定的微量蛋白尿与代谢综合征（MetS）及其在各年龄、性别和估算肾小球滤过率（eGFR）类别中的组成成分之间的关联。
纳入了总共270,190名年龄在40 - 74岁的人群（102,223名男性和167,967名女性）。通过试纸法将受试者分为蛋白尿阴性、微量和阳性。
在任何估算肾小球滤过率（eGFR）类别中，MetS的患病率均随蛋白尿水平升高而增加（eGFR≥90、60 - 89和45 - 59 ml/min/1.73 m²的受试者中，微量蛋白尿相对于阴性蛋白尿的MetS比值比分别为1.22、1.23和1.25，阳性蛋白尿的比值比分别为2.19、1.81和1.80）。这些关联在各年龄和性别类别中均具有统计学意义。在MetS的组成成分中，高血压和糖尿病的患病率随蛋白尿水平升高而增加（微量和阳性蛋白尿的高血压比值比分别为1.23和1.87，糖尿病比值比分别为1.28和2.18），在任何eGFR类别中均有类似观察结果。蛋白尿水平之间腹部肥胖和血脂异常（高密度脂蛋白胆固醇降低和/或甘油三酯升高）的患病率几乎没有差异。
在一大群普通人群中，通过试纸法测定为微量蛋白尿的受试者在任何eGFR类别中，发生MetS、高血压和糖尿病的风险介于蛋白尿阴性和阳性受试者之间。因此，即使对于eGFR正常的微量蛋白尿受试者，也应检查其MetS的组成成分，以便早期预防心血管疾病。
