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巴西少数民族裔高血压患者的肾脏损伤标志物与颈动脉粥样硬化的关系。

Association between renal damage markers and carotid atherosclerosis in Afro-descendants with hypertension belonging to a minority ethnic group from Brazil.

机构信息

a Postgraduate Program of Health Science, Federal University of Maranhão , São Luís , Brazil.

b Nephrology Division, University Hospital of Federal University of Maranhão , São Luís , Brazil.

出版信息

Ren Fail. 2018 Nov;40(1):483-491. doi: 10.1080/0886022X.2018.1496932.

Abstract

Ethnicity appears to play an important role in the prevalence and severity of hypertension, renal disease, and atherosclerosis. A cross-sectional study was conducted, including 206 Afro-descendants with hypertension, living in the remaining quilombo communities. These subjects underwent a carotid intima-media thickness (CIMT) assessment. The presence of renal injury was assessed by: (1) The glomerular filtration rate (GFR) estimated by the formula CKD-EPI using creatinine and cystatin C and (2) Albuminuria (ACR ≥30 mg/g). The Poisson distribution model was set with robust variance to identify factors associated with carotid atherosclerosis. The statistical analysis was performed using the Stata 12.0 software, adopting a significance level of 5%. Most subjects were women (61.65%); the average age was 61.32 (±12.44) years. Subjects (12.62%) were identified with GFR <60 mL/min/1.73 m and 22.8% with albuminuria. Patients (59.22%) presented with a high CIMT. In the adjusted regression model, age ≥60 years (PR: 1.232 [CI 95%:1.091-1.390], p value = .001), ACR ≥30 mg/g (PR: 1.176 [CI 95%: 1.007-1.373], p = .040), and GFR/CKD-EPI using cystatin C (PR: 1.250 [CI 95%: 1.004-1.557], p = .045) were independently associated with carotid atherosclerosis. The occurrence of atherosclerotic lesions was high in the studied group. Age, albuminuria, and GFR (estimated by the formula CKD-EPI using cystatin C) influenced the prevalence of carotid atherosclerosis.

摘要

种族似乎在高血压、肾脏疾病和动脉粥样硬化的患病率和严重程度方面起着重要作用。进行了一项横断面研究,包括居住在剩余 quilombo 社区的 206 名非裔高血压患者。这些受试者接受了颈动脉内膜中层厚度 (CIMT) 评估。通过以下两种方法评估肾脏损伤的存在:(1) 使用基于肌酐和胱抑素 C 的 CKD-EPI 公式估算肾小球滤过率 (GFR),以及 (2) 白蛋白尿 (ACR≥30mg/g)。采用稳健方差的泊松分布模型来确定与颈动脉粥样硬化相关的因素。使用 Stata 12.0 软件进行统计分析,采用 5%的显著性水平。大多数受试者为女性 (61.65%);平均年龄为 61.32(±12.44)岁。有 12.62%的受试者肾小球滤过率 (GFR) <60ml/min/1.73m,22.8%的受试者白蛋白尿。59.22%的患者 CIMT 较高。在调整后的回归模型中,年龄≥60 岁 (PR:1.232[95%CI:1.091-1.390],p 值=0.001)、ACR≥30mg/g (PR:1.176[95%CI:1.007-1.373],p=0.040) 和 GFR/CKD-EPI 使用胱抑素 C (PR:1.250[95%CI:1.004-1.557],p=0.045) 与颈动脉粥样硬化独立相关。在所研究的组中,动脉粥样硬化病变的发生率很高。年龄、白蛋白尿和 GFR(使用 CKD-EPI 公式估计胱抑素 C) 影响颈动脉粥样硬化的患病率。

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