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在一个没有慢性肾病的代表性韩国人群中,代谢参数与肾小球高滤过之间的关系。

Association between metabolic parameters and glomerular hyperfiltration in a representative Korean population without chronic kidney disease.

机构信息

Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea.

Division of Endocrinology and Metabolism, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Gyeonggi-do, Republic of Korea.

出版信息

PLoS One. 2018 Dec 6;13(12):e0207843. doi: 10.1371/journal.pone.0207843. eCollection 2018.

Abstract

AIMS

To investigate associations of glomerular hyperfiltration with other metabolic factors in a nationally representative dataset.

METHODS

We analyzed cross-sectional data from 15,918 subjects with estimated glomerular filtration rate (eGFR) >60 ml/min/1.73 m2 and urine albumin creation ratio (ACR) <30 mg/g, who participated in the 5th and 6th Korea National Health and Nutrition Examination Surveys. Hyperfiltration was defined as eGFR (CKD-EPI equation) exceeding the age- and sex-specific 95th percentile for healthy control subjects.

RESULTS

Prevalence of hyperfiltration was 5.2% and that among normal, prediabetic, and diabetic subjects was 4.9%, 5.6%, and 7.3%, respectively, after adjusting for age, sex, and body weight (p for trend = 0.008). In a multiple logistic regression analysis, hyperfiltration was associated with a body mass index ≥30 kg/m2 [odds ratio (OR) = 3.461, p<0.001], waist circumference 85 cm (men) or 80 cm (women) (OR = 1.425, p = 0.015), systolic blood pressure 120-129 mmHg (OR = 1.644, p = 0.022), fasting plasma glucose 140 mg/dL (OR = 1.695, p = 0.033) and t serum triglyceride level 500 mg/dL (OR = 2.988, p = 0.001), and was independently associated with the ACR (B = 0.053, p<0.001).

CONCLUSIONS

In a general Korean population, both hyperfiltration and ACR were associated with similar metabolic parameters, and hyperfiltration correlated independently with a high ACR. Longitudinal studies are needed to further explore risks of hyperfiltration and microalbuminuria.

摘要

目的

在具有全国代表性的数据集内,调查肾小球高滤过与其他代谢因素之间的关联。

方法

我们分析了参加第 5 次和第 6 次韩国国家健康和营养检查调查的 15918 名肾小球滤过率(eGFR)>60 ml/min/1.73 m2 且尿白蛋白肌酐比值(ACR)<30 mg/g 的患者的横断面数据。肾小球高滤过定义为 eGFR(CKD-EPI 方程)超过健康对照人群的年龄和性别特异性第 95 百分位数。

结果

调整年龄、性别和体重后,高滤过的患病率分别为正常、糖尿病前期和糖尿病患者的 4.9%、5.6%和 7.3%(趋势 p 值=0.008)。在多元逻辑回归分析中,高滤过与体重指数≥30 kg/m2[比值比(OR)=3.461,p<0.001]、腰围 85 cm(男性)或 80 cm(女性)(OR=1.425,p=0.015)、收缩压 120-129 mmHg(OR=1.644,p=0.022)、空腹血糖 140 mg/dL(OR=1.695,p=0.033)和 t 血清甘油三酯水平 500 mg/dL(OR=2.988,p=0.001)相关,且与 ACR 独立相关(B=0.053,p<0.001)。

结论

在韩国普通人群中,高滤过和 ACR 均与相似的代谢参数相关,且高滤过与高 ACR 独立相关。需要进行纵向研究以进一步探讨高滤过和微量白蛋白尿的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a19/6283579/0fecb55c1609/pone.0207843.g001.jpg

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