Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National clinical research center for geriatrics diseases, State Key Laboratory of Kidney Diseases, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China.
BMC Nephrol. 2019 Jan 15;20(1):20. doi: 10.1186/s12882-019-1202-8.
This study aimed to examine the relationship between 25-hyfromxyvitamin D (25OHD) and chronic kidney disease (CKD) incidence.
All the elderly who had participated both in the 2011-2012 survey and 2014 survey in the Chinese Longitudinal Healthy Longevity Survey (CLHLS), and have biomarker data were included in the analysis. We studied those without CKD with complete data at 2011-2012 waves. Serum 25-Hydroxyvitamin D was assessed at baseline. Cox proportional risk model was used to evaluate associations between serum 25-Hydroxyvitamin D and CKD (including both albuminuria and impaired eGFR) incidence after adjusted for potential confounding..
During the follow-up years, 255 incident cases of CKD were diagnosed. Those who developed CKD had relatively lower serum 25(OH)D (mean 37.63 vs.51.36 nmol/L, p < 0.001) compared with those who remained free of CKD. Each 1 nmol/L increase in 25(OH)D was associated with 3.4% reduced risk of CKD (HR = 0.966, 95%CI: 0.959-0.973) after adjusted for related covariates. The HRs of each 1 nmol/L increase in 25(OH)D for albuminuria and impaired eGFR were 0.952(95%CI: 0.941-0.963) and 0.975(95%CI: 0.966-0.983) respectively. When use the classifications (sufficiency, insufficiency, deficiency) or quintiles of baseline 25(OH)D levels in the Cox model, the corresponding HRs showed an increasing trend along with the decrease of baseline 25(OH)D levels (p for trend < 0.001).
Higher 25(OH)D levels were inversely and independently associated with CKD incidence among Chinese elderly. The trend for the observed linear relationship b was most pronounced among the lowest quintile.
本研究旨在探讨 25-羟维生素 D（25OHD）与慢性肾脏病（CKD）发病之间的关系。
所有参加中国长寿纵向研究（CLHLS）2011-2012 年调查和 2014 年调查的老年人，且有生物标志物数据的人都纳入了分析。我们研究了在 2011-2012 年波次时没有 CKD 且数据完整的人群。在基线时评估血清 25-羟维生素 D。采用 Cox 比例风险模型评估血清 25-羟维生素 D 与 CKD（包括白蛋白尿和肾小球滤过率受损）发病风险之间的关系，调整潜在混杂因素后。
在随访期间，诊断出 255 例 CKD 病例。与未发生 CKD 的人群相比，发生 CKD 的人群血清 25(OH)D 水平相对较低（平均 37.63 vs.51.36 nmol/L，p < 0.001）。血清 25(OH)D 每增加 1 nmol/L，CKD 发病风险降低 3.4%（HR=0.966，95%CI：0.959-0.973），调整相关协变量后。血清 25(OH)D 每增加 1 nmol/L，白蛋白尿和肾小球滤过率受损的 HR 分别为 0.952（95%CI：0.941-0.963）和 0.975（95%CI：0.966-0.983）。当在 Cox 模型中使用基线 25(OH)D 水平的分类（充足、不足、缺乏）或五分位数时，相应的 HR 随着基线 25(OH)D 水平的降低呈上升趋势（p<0.001）。
较高的 25(OH)D 水平与中国老年人 CKD 发病呈负相关且独立相关。观察到的线性关系 b 的趋势在最低五分位数中最为明显。
