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血清高敏C反应蛋白水平升高及身体成分与慢性肾脏病的关联:一项基于台湾人群的研究

Association of elevated blood serum high-sensitivity C-reactive protein levels and body composition with chronic kidney disease: A population-based study in Taiwan.

作者信息

Tsai Yi-Wen, Chan Yi-Ling, Chen Yi-Chuan, Cheng Yiu-Hua, Chang Shy-Shin

机构信息

Department of Family Medicine, Chang Gung Memorial Hospital, Keelung and Chang Gung University College of Medicine Departments of Emergency Medicine Departments of Family Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Linkou, Taoyuan Department of Family Medicine, Taipei Medical University Hospital and Taipei Medical University College of Medicine, Taipei, Taiwan.

出版信息

Medicine (Baltimore). 2018 Sep;97(36):e11896. doi: 10.1097/MD.0000000000011896.

DOI:10.1097/MD.0000000000011896
PMID:30200074
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6133564/
Abstract

Chronic kidney disease (CKD) is a risk factor for cardiovascular diseases and is associated with an increase in all-cause mortality. Studies regarding association among various body compositions in different inflamed states and the risk of CKD were rare. We aimed to evaluate the relationship among body composition, high-sensitivity C-reactive protein (hsCRP) level, and the risk of CKD.This was a retrospective cross-sectional study using annual health examination data from 2 medical centers in northern and southern Taiwan between January and December 2015. We performed a variance analysis of the estimated glomerular filtration rate (eGFR) distribution in groups based on hsCRP and body fat percentage (BFP), and a multivariate logistic regression model was used to assess the relationship among BFP, hsCRP levels, and CKD.A total of 10,267 subjects aged ≥18 years undergoing health examination were analyzed. In our study, overweight/obese patients were associated with increased risk of CKD. Nevertheless, in subjects with elevated hsCRP level, overweight/obese group with a higher BFP had a lower risk of CKD as compared with overweight/obese with normal BFP group (for BMI ≧ 23 kg/m, high BFP/high hsCRP: odds ratio [OR] for CKD 1.86, 95% confidence interval [CI] = 1.10-3.17, P = .02; normal BFP/high hsCRP group: OR 2.32, 95% CI = 1.23-4.37, P = .01) after adjusting for various confounders.Our findings suggest that various body compositions in different inflamed states may interfere with the risk of CKD. These results provide an important method for the early detection of impaired renal function by identifying various body compositions and inflammation states to detect CKD at an earlier stage.

摘要

慢性肾脏病(CKD)是心血管疾病的一个危险因素,并且与全因死亡率的增加相关。关于不同炎症状态下各种身体成分之间的关联以及CKD风险的研究很少。我们旨在评估身体成分、高敏C反应蛋白(hsCRP)水平与CKD风险之间的关系。

这是一项回顾性横断面研究,使用了2015年1月至12月台湾北部和南部2个医疗中心的年度健康检查数据。我们基于hsCRP和体脂百分比(BFP)对各组的估计肾小球滤过率(eGFR)分布进行了方差分析,并使用多因素逻辑回归模型来评估BFP、hsCRP水平与CKD之间的关系。

总共对10267名年龄≥18岁接受健康检查的受试者进行了分析。在我们的研究中,超重/肥胖患者患CKD的风险增加。然而,在hsCRP水平升高的受试者中,与正常BFP的超重/肥胖组相比,BFP较高的超重/肥胖组患CKD的风险较低(对于BMI≧23kg/m,高BFP/高hsCRP:CKD的比值比[OR]为1.86,95%置信区间[CI]=1.10 - 3.17,P = 0.02;正常BFP/高hsCRP组:OR 2.32,95% CI = 1.23 - 4.37,P = 0.01),在调整了各种混杂因素之后。

我们的研究结果表明,不同炎症状态下的各种身体成分可能会干扰CKD的风险。这些结果提供了一种重要的方法,通过识别各种身体成分和炎症状态来在更早阶段检测CKD,从而早期发现肾功能受损。

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